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Cholestasis, Incompetent Cervix – How it Changed My World

The Beginning Was So Easy

The beginning of my pregnancy with Jacob was easy – no, it was. I loved it. There wasn’t any morning sickness (thank goodness). Most days I woke up feeling pretty darn normal. I commuted to work from the ‘burbs to the city (about a 45 minute express commute in the morning). Then I had a 10 minute walk from the train to the office. My job was stressful, but I had managed it already for 5 years, no big deal. The fateful diagnosis of Cholestasis and Incompetent Cervix was yet to rear its head. Yep, there was nothing out of the ordinary.

At least, not in the beginning…

Incompetent Cervix

Did you ever wonder, before you got pregnant, what it was that kept the baby in place? You know, so your amniotic sac doesn’t just fall out? (LOL!) I’ll tell you. It’s your cervix – that muscle that separates the vagina from the uterus. This muscle is what keeps the amniotic sac and placenta from straight up falling out of your vagina. (Pretty graphic image there, thanks Luma.) Clearly, it plays a HUGE role. During your pregnancy your obstetrician will check your cervix at least twice. If this is your second pregnancy, but you didn’t have any complications during the first pregnancy, it may be fewer checks. Let me tell you something, my previous pregnancy was pretty damn near normal (except the killer morning sickness that didn’t seem normal, but I digress).

So, herein lies the problem: I have an incompetent cervix. My cervix is a bitch. I hate it. (Strong words, I know.)

First, let me explain what an incompetent cervix is. An incompetent cervix is a condition that occurs when weak cervical tissue causes or contributes to premature birth or the loss of an otherwise healthy pregnancy. Basically, your cervix is supposed to be nice and tight and protective during pregnancy. It’s supposed to be like the sentinels that protect the tomb of the unknown soldier – unwavering, resilient, proud.  Mine was more like – I quit. After 8 months of holding it down, it just quit. That would be like the sentinels holding their post until the last few hours before deciding they just didn’t want to “walk” anymore. Um, they’re not suppose to do that and neither is your cervix.

Cholestasis of Pregnancy

If you ever wanted to torture somebody, for whatever reason, I suggest making them somehow intensely itchy. Seriously, it will drive them INSANE! How do I know? Been there, done that (as in, I, personally, was itchy not that I actually tortured another person – because I didn’t).

So, WTF is “Cholestasis of Pregnancy”?  Basically, you already know one of the most important parts – it makes you EXTREMELY itchy.

It started with itching on the bottoms of my feet. I thought at first it was an allergic reaction or that the faux fur lined snow boots I was wearing were the culprit. The problem with both those things was that the itching never stopped (this itching is evil). Imagine trying to figure out how you can walk but also scratch your feet simultaneously ALL DAY. Then imagine rubbing the palms of your hands together CONSTANTLY. So much so that you don’t get much work done because you can’t even type. You itch so much that you can’t eat properly either. Know what, you can’t think, because all you think about is how much you want the itching to stop.YOU KNOW WHAT? YOU CAN’T SLEEP EITHER! (Caps were necessary, very necessary.) So, yep, pretty bad. Also, you’re pregnant – already hard – but MOST importantly it’s bad for the baby.

The End

So at the recommendation of my husband after almost a week of itchiness I made an appointment with my obstetrician. (I think the nurse thought I was crazy for making an appointment because my feet were itchy.) The day of the appointment, as soon as I mentioned the symptoms to my doctor, I was immediately sent to do blood work. Mind you, my appointment was at 530pm and the lab closed at 6pm. Luckily, the lab was on the same floor; however, the nurse had to rush me out the door and call the receptionist at the lab so they wouldn’t lock the doors. The whole rushing scenario made me extremely nervous. The doctor wanted the results first thing in the morning and she said she would call me immediately after she got them. I went home freaking out (internally anyway).

So, the next morning I got a phone call with the diagnosis. I had to book an appointment immediately with a maternal fetal medicine specialist because I needed to be on special medication and I needed to start NSTs (non stress tests) to monitor Jacob for distress (shit). This was a big deal. My husband and I were worried. I started medication, I had to have bi-weekly NSTs (while somehow also working downtown – my doc is in the ‘burbs). Also, did I mention this was right before Christmas week? Crazy. Anyway, I went through almost 3 weeks of testing and constant appointments with the obstetrician and MFM. Three weeks of constant research trying to figure out what I could do to keep me, and my son, relatively healthy. So, here comes the other half of the shit show. My own body betraying me even more!

At 4am on January 8 at 35 weeks pregnant I was having contractions. Just boom! Out of nowhere. At first I thought Braxton hicks. Then they became pretty evenly timed. I emailed work that I wasn’t coming in. We called my mom immediately too she had to drive from the city to my house at 6am, and had to hurry! Denise had to get to school and I couldn’t leave her alone! By 7am I was panicking and my contractions were so strong! As soon as my mom was in the driveway we rushed out, bags packed and everything! Finally, 9:24am January 8 Jacob was born at 5lbs 6oz, 19in long. My baby was here! Except for one giant problem: he was premature. (I’ll have a separate blog post where I talk about having preemie babies.)

So, why TF did I just start having contractions out of nowhere and so strongly? It was IC – incompetent cervix. I did not have any issues with Denise so it was never checked (other than what the routine checkups are for a normal pregnancy). At the time it had been about 8 years since I had been pregnant with her. The obstetrician never thought it was an issue, and neither did I, obviously.

To this day I constantly think this could have happened on the train to work. That I could have gotten ready and hopped on my train and been halfway there, and then BOOM contractions! Stop the train! Pregnant lady here trying to birth a child on the nasty, dirty, grimy, floor of the train. Then I would have been on the news! How embarrassing! Anyway… not important. It didn’t happen and I am grateful.

The Beginning, Again…

So, why am I telling you this? Honestly? I just want you to know I want to help. In my research during the three weeks of constant testing I learned a few things.

The first being that current research doesn’t understand why Cholestasis happens. The second being that the occurrence of it varies from country to country (weird). The third, and in my opinion most important, there are doctors that don’t even test for it when patients complain of having the same symptoms as Cholestasis.

I don’t even know how many forums, blogs, pregnancy sites, comments, and whatnot, I read through where women commented they had to either switch doctors (because their current one didn’t believe there was anything wrong), bring the door down on their current doctors (fucking take my blood, dammit!) or go to the emergency room and basically lie and say their baby was in distress to get tested.

Why? I didn’t understand. All it took was a blood test (maybe two, I don’t remember). Especially when Cholestasis, if left untreated can be fatal to your baby. Especially, when it is treated doctors have to induce you at 37 weeks because waiting any longer can be fatal for your baby. Like, holy shit, why wouldn’t they test?

Then comes having an incompetent cervix… This one is a wholly different wormhole. I didn’t do much research into this one when I was pregnant with Jacob. Actually, I didn’t find out I had IC until I was pregnant with the twins, but once I knew, it clicked. I couldn’t understand how I could have gone through birthing Jacob so quickly (not that there aren’t women out there who are perfect birthers) when I had such a hard birth with Denise. It just didn’t make sense. Regardless, this part didn’t affect me as much until I had to deal with my pregnancy with the twins. It was during that pregnancy that I started to hate my cervix so much. We’re still not on good terms, but it’s not like I can just get rid of it.

Anyway…

If you are currently pregnant and feel like something isn’t right then go get checked. I don’t care if the nurses look at you funny – just do it. Also, I know a significant amount of people say “don’t google it!” or “if you google it you’ll feel worse!”, but be a rebel and google away. Do your research. Be informed. BE YOUR OWN ADVOCATE. LEARN. It’s important for you and for your baby. HOWEVER, try your best to look at it from a third party’s perspective. Don’t go on an emotional roller coaster (even though I know it’s hard).

Lastly, find a good doctor and work with him/her. Ask lots of questions. My last MFM (Maternal Fetal Medicine) loved to send us the medical journals that he based his decisions on. It comforted us to know that he was on top of his medical research constantly. Also, we’re weird and love to read and research things. I think we were his favorite patients.

So there it is. I’m happy I’m able to share this here. I hope someone out there finds it useful. Jacob is now a happy, healthy, almost 3 year old. Time flies.

P.S., I know there is an issue around having cervical checkups for some women due to privacy, female body empowerment, and too much medical outreach among other things. Everyone’s opinion is different, you guide your daily life based on what you think is best for YOU. I’m not trying to say here that you should have more cervical checkups but only that there is a condition that is hard to diagnose until the perfect conditions are met. So, what I am saying is you should do your research, listen to your body, and TALK to your doctor. And if the dude (or dudette) doesn’t want to even hear your side of the story then find someone else. Period.

 

Disclaimer: I am not a medical professional. The information contained in this blog post is not meant to assist in diagnosing any medical condition. Diagnosing medical conditions is the job of a medical professional; I am not a medical professional. The sole purpose of this blog post is to inform the reader of my personal experiences.

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