Midwifery Care and a Complicated Pregnancy

A recent client developed cholestasis of pregnancy.  This is a complication of pregnancy that causes maternal bile acids to build up in her blood stream.  The bile acids cross the placenta and put the baby at risk for still birth.  Induction of labor, hopefully at term, is indicated to protect the baby.  After consulting with a maternal fetal medicine physician, the plan was made to monitor the well being of the baby with non stress testing (listening to the baby’s heart beat and observing for accelerations of the heart beat when the baby moved) to reassure us that the baby was not in danger while we awaited full term at 37 weeks of pregnancy.  The mother was then admitted to the hospital and her labor was induced.  After 30 hours the mother had a normal delivery and achieved her wish to have an unmedicated birth.  The midwife stayed at her side throughout active labor, coaching her as she floated in the soaking tub.  She gave birth in the position of her choice without requiring any intervention and with an intact perineum.