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Choleostatis & Home Birth

My lovely client contacted me mid way through her pregnancy to book me as her Birth Photographer for her 5th baby. We hit it off instantly (because I'm that sorta gal!) & a week later I visited her at her home in Weymouth.

Natalie was diagnosed with Cholestasis just after her 20 week scan. She had the condition in her previous pregnancy where she ended up being induced, something she didn't want to happen this time due to trauma. Cholestasis in pregnancy ( aka Intrahepatic cholestasis of pregnancy - ICP) triggers intense itching with no rash. In ICP bile acids do not flow properly from your liver to your gut & instead build up in the body. The condition is monitored by regular blood tests.

Natalie's bile acids for the most part stayed under 10 but at around 36 weeks there was a question over baby's growth so Natalie was sent for a scan where baby was fine but amniotic fluid 'appeared' to be higher than normal. She was then passed to a 'registrar' who in Natalie's exact words 'wanted to shit all over my plans for a home birth'. Natalie was sent home with a blood sugar monitor to check for diabetes - even though baby wasn't measuring big and she had had a normal GTT result earlier in her pregnancy. Luckily for Natalie she had an awesome midwifery team who advocated on her behalf, queried the scan result and helped dismiss the GTT and she continued with her plans for a homebirth.

After having a sweep at 38 weeks one morning, by the evening surges were 7-10 minutes apart. An hour later they were very 5-6 minutes and lasting 30-40 seconds so because it was an hour's journey and this was baby number 5 (babies tend to get quicker!) I left at 830pm, arriving by 940pm.

In between surges Natalie was chatting away, even receiving a phone call from one of her teenage daughters who was at a sleepover and asking for more data which made us all laugh. As transition began to hit the gas and air came out at Natalie's request

The Cygnet Home Birth Team were an incredible support, hands off for the majority and hands on only when needed.

Baby Isaiah was born at 0138 weighing 6lb 14oz. He let out a beautiful big cry in his Mama's arms. About 60 seconds later Isaiah did start to go quiet and floppy in mums arms. He was still attached to the placenta so was still receiving oxygen and his heart rate was good. Some of the pool water was gently splashed on him to try and alert him enough to remember to breathe but in the end some inflation breaths were performed with the mask and bag which did just enough to help his little lungs get going.

It's important to remember that Home Birth teams are more than well equipped to deal with these situations. Should this have happened in a hospital I can guarantee that Isaiah's cord would have been cut immediately. Because of no oxygen then coming from the placenta his oxygen levels would have fallen further & he would have remained away from his Mama for longer and maybe even taken to a different ward for monitoring. Instead in this home situation, he was placed back on Mama to have skin to skin, kept in the warm water of the birth pool, stayed attached to the placenta still having his oxygen and in turn became alert and pinked up quickly.

Welcome to the World Isaiah! Your Mama fought hard to give birth to you at home. She stood up for what she believed was right for her and for you, had a wonderful Homebirth Team advocating for her & absolutely smashed it!

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