Four years ago today our sweet, silly, artistic, sensitive, curious little Eli entered the world. I think that all mothers probably take time on their children’s birthdays to reflect on the details of their births (or adoptions); at least I know I do. And it has become somewhat of a trend these days in the blogosphere to write birth stories. I love reading them, but I never thought I would have any significant reason to share mine. Until Eli. I think sometimes I still have a hard time processing how close we came to the possibility of losing him.
The first half of my pregnancy with him was pretty uneventful. I was ridicuoulsy sick, just as I had been with my first son, but nothing more than what many expectant mothers deal with. I was disappointed when my nausea and vomiting didn’t decrease at the start of the second trimester, but by about 20 weeks, I was finally beginning to feel a bit less sick. But almost as soon as I stopped feeling green, I began to feel blue. I had never had postpartum depression (or any kind of depression, for that matter), but I knew immediately that was what I was experiencing. I lost interest in everything. I didn’t want to see anyone or go anywhere. My friends suggested that I talk to my OB about it, so at my 22 week checkup I told him how I was feeling. He felt that it was hormonal and wanted to start me on medication. At the time, I didn’t know that depression was just the first symptom of things to come. I was also chasing a very active 2-year-old so I was naturally tired, but it got to the point where I couldn’t make it through the day without taking a long nap. Any physical exertion, even simply picking up toys off of my son’s bedroom floor, completely and utterly exhausted me. And I began to crave ungodly amounts of water. I knew–just knew–that I was not going to make it to my due date in September.
At the beginning of June I began to have frequent contractions. I went in to the doctor and the OB on call told me that I was probably just dehydrated from the summer heat and needed to drink more water. By that point, I was already drinking a couple of gallons a day. I told her, but I don’t think she believed me. She put me on bedrest for three days and told me after that I could resume normal activity. I didn’t tell her that my normal activity was already resting as much as I could and chugging tons of water. So three days later, I still remained tired and contracting. And thirsty. I was so, so thirsty.
At 3 AM one morning, just past 33 weeks, I awoke with significant contractions. By 6 AM, they were two minutes apart. When we got to the hospital, a flurry of activity commenced. I was hooked up, IV’d up, shot up, and charted up. Since I was definitely in labor, the NICU reps came to talk to me about what to expect if I was to deliver my baby boy 7 weeks early. But the magnesium worked and the contractions stopped. They made me stay two full days. I remember not wanting any visitors except my immediate family and my small group. I also remember feeling like I had been hit by a truck or had the flu. But what I remember most vividly was how they rationed my water. I still could not get enough water to quench my thirst. They only allowed me to have 20 ounces an hour because the medication I was on required constant monitoring of the kidneys. It wasn’t enough. My friends (God bless them) were sneaking me water and sips of iced tea. I drank my 20 oz around the clock, even throughout the night…waiting on 2 AM, 3 AM, 4 AM. The clock wouldn’t strike soon enough. The nurses said they had never encountered anyone who needed that much water. 20 oz an hour is almost 4 gallons a day. And I was still parched.
I was discharged and ordered on strict bedrest for the remainer of the pregnancy. But 48 hours later I was back in the hospital with contractions again. The OBs kept stopping my labor because, at the time, they didn’t realize that my body was doing everything it possibly could to get my baby OUT. Even physiologically, mothers are fierce protectors of their children.
Finally, by 35 weeks, the contractions had begun to slow down. AND THAT IS WHEN THE ITCHING BEGAN. I’ve thought and thought about how to describe the itch properly to someone who hasn’t experienced it. It was mild at first, so most people can relate to that. It was a little like hay fever–like when you’ve been outside all day and you are a bit sneezy and itchy in the evening. For the first week, the itch was kind of like that. I almost didn’t notice it; I scratched subconsciously. As I neared 36 weeks, the itching began to wake me up at night. At my 36 week appointment I mentioned it to my OB and he said he would run some bloodwork, but he wasn’t very concerned. I went home and back to my bedrest. With my water.
But by mid-week everything changed. I still have no words to describe the severity and intensity of the itching. It began on my hands and feet, but then spread to every last millimeter of my body. I itched inside of my ears. I itched 24 hours a day. I scratched myself all over, all night long, to no relief. I scratched my legs until they bled (I still have scars). It was as if every single inch of the underside of my skin was covered with mosquito bites…but WORSE. I had no rash. I had no bumps. But I was clawing myself to death. I would scrape my bare feet on the concrete sidewalk in front of our home. I couldn’t be more than 3 feet away from a wire hairbrush to assist in my scratching. At one point I saw the steak knives in our kitchen drawer and thought “those would feel SO GOOD on my feet.” The itch was making me insane.
After three nights with zero sleep from scratching, I staggered–a bleary eyed mad woman–into my 37 week appointment. My OB was stumped. But he knew something was wrong and he had to help me. He told me that he was going to get me an appointment with a dermatologist immediately and left me in the room with my 2-year-old to go make the call. I was crying and scratching and bleeding and trying to read a book to Will when the doctor walked back into the room 15 minutes later. “You need to get to the hospital immediately. We are delivering this baby right now.” I stammered, shocked and confused. He told me that on the way to call the dermatologist, he had a hunch. And so, instead, he called a perinatologist to discuss it. After describing my symptoms and gestation to him, the perinatologist told him to deliver me IMMEDIATELY. So I made arrangements for my toddler, and my husband and I walked into labor and delivery around noon. The pitocin began at 12:30 and our precious Eli Harrison was born at 4:26. less than four hours after induction. As soon as he was born, the itching and thirst began to dissipate. I had just given birth after three completely sleepless nights, and yet I felt as if I could hop out of my hospital bed and run a marathon. When my OB came by to check on me the next day, I finally found out why.
I was told that I had a condition called Intrahepatic Cholestasis of Pregnancy (or ICP). ICP is basically pregnancy-induced liver failure. Unbeknownst to me or my OB, my liver had stopped working properly and bile was pooling in it, until (like a sponge) it became saturated. When it could hold no more, bile acids began spilling into my blood stream and making my own body a toxic environment for my precious baby. It took months of research after Eli’s birth for me to realize how serious the situation really had been. In one week, my bile acid levels had increased from within normal range at 36 weeks to OVER SIX TIMES the normal maximum levels at 37 weeks. I was well past what is referred to as “severe” ICP, which is the most dangerous level for the baby. Because, while ICP has little risk for the mother, there is great risk for the baby in utero. There still isn’t a lot that is understood, but a baby can be perfectly fine and happy during a non-stress test in the morning, but experience sudden and instant death by the afternoon. And the risk for sudden infant demise due to ICP increases SIGNIFICANTLY after 37 weeks, especially if bile acid levels are in the severe range, as mine were. Eli was born at 37 weeks exactly.
I don’t think a day goes by without me thanking God for that “hunch” he gave my OB four years ago today. ICP is rare (less than 1 in 1000), and I was the first case my OB had ever seen, which is why he didn’t recognize the symptoms earlier. I shudder to think of what would have happened if he had sent me on to the dermatologist because he didn’t see what was happening. One more week…even one more day…and we could have had a totally different story to tell. But there was One who DID know, who DID see. As I was chugging water and trying to stop contractions and clawing myself obsessively, God was watching over and protecting our precious boy.
“My frame was not hidden from you, when I was being made in secret, intricately woven in the depths of the earth. Your eyes saw my unformed substance; in your book were written, every one of them, the days that were formed for me, when as yet there was none of them.” Psalm 139:15-16
I don’t know the plans that God has for our beloved boy, but I am so grateful that He protected him, allowed him to be born healthy, and has given us these past four years with him. It’s true that his little life began with an amazing birth story that testifies to God’s love and faithfulness, but it is my constant prayer that the incredible story God is writing with his life has only just begun.
We love you, precious boy. Happy 4th Birthday.
For more information about ICP, visit www.icpcare.org