ICP Care Team Volunteer

Amparo Healey Board Member
April Hubbard
Communication Specialist
Amparo Healey Board Member
Communication Specialist
April Hubbard

Hi! My name is April Hubbard. I am a Volunteer with ICP Care. I am passionate about raising awareness of ICP—what the disorder is, what it means, what it can do, and why proper treatment in pregnancy is important!

I have three beautiful children on earthside. My oldest child will be 15 in June, my middle child will be 7 in June and my baby will be 3 in May. I also have an incredibly supportive husband.

My cholestasis of pregnancy journey began with my middle child, my first boy. At around 32 weeks, I started itching. It was bad – to the point where I was trying everything. I tried so many lotions – but none worked. I tried Benadryl, many creams, and I even tried oatmeal baths, where I sat in the tub with oatmeal to try to soothe my skin — it made it soft but didn’t stop the itch. I then, as a last resort, thought maybe I was allergic to my two cats and their dander, so I vacuumed my entire house, since it was carpet, and I gave my two cats baths. They were NOT happy, as you can imagine, and the itch didn’t go away! It was truly the worst itch ever. On my hands, my feet, and my stomach. So, finally, as desperate as I was, I complained to my OBGYN.

My OB was doubtful it was anything, and she sent a referral to dermatology. A dermatologist looked at my skin and told me that it was not a skin disorder, but that she thought it might be PUPPS or cholestasis. I had never heard of either of these things, so I went to Google and started reading. PUPPS stands for Pruritic Urticarial Papules and Plaques of Pregnancy, and carries its own risks in pregnancy, but my symptoms did not fit this. My mama gut was telling me that something was off. My symptoms fit cholestasis, so I went back to my OBGYN and insisted she run some lab work.

My OBGYN ran my liver enzymes, which have always been elevated because of my liver disease (I have NASH and Mitochondrial Hepatopathy) but they were through the roof, and so she ordered bile acid blood testing.

My bile acids came back at 14.6 umol/L She did not want to start me on the medication Ursodiol just yet, she wanted to run the test one more time to see if they increased. At 33 weeks, my bile acids came back almost triple what they were, which now the total bile acids were 45.4 umol/L and so we had to do something. My OB/GYN prescribed Ursodiol and scheduled me for weekly NSTs, and monthly growth scans/biophysical profile scans.

My bile acids drastically decreased with the use of Urso, and I was induced with my son who was delivered via vaginal induction with Pitocin at 38 weeks. I had a birth doula who helped me advocate for what I wanted with my delivery since I had birth trauma from my oldest child – my daughter.

Everything went as planned with my delivery with my little man and he came quickly! He was born June 8th, 2017, at 6lbs 5oz and he was the cutest thing ever.

After I had my son, I was fortunate enough that the itching stopped, but some women are not that lucky. Unfortunately, I continued to have symptoms of pain in my liver area, so an ultrasound was ordered, which discovered a lot of “sludge” and several gallstones. I was told to change my diet, and these would go away, and I would follow up with my Hepatologist for my normal fibro scan testing yearly.

I put the visit with the Hepatologist off (don’t do this!!!) because I wanted to have another child. My husband and I went through infertility treatments for about a year before we conceived our now almost 3-year-old. Our pregnancy with him was rough.

I suffered from severe hyperemesis which was complicated by my gastroparesis, and diabetes. I was on insulin in the first trimester, which is unheard of, and I was in and out of the hospital due to severe dehydration and my doctor’s refusal to do a PICC/IV Fluids at home. I became a “frequent flyer” and couldn’t even keep water down – to where they went back and forth on placing a tube, but determined it was too risky.

When I hit second trimester and about 20 weeks of pregnancy, the dreaded itching began. One of my friends had seen my post and told me that if I had ICP with my first son, that chances are I’d have it again, and told me to advocate for myself – and she introduced me to the group ICP Care. This was the best thing ever, because I was already struggling with such a rough pregnancy, and I was miserable.

I thought because my OBGYN knew my history from ICP before, that she would just start me on Urso, but she refused. Instead, she told me that we were already inducing labor early, and that it wouldn’t change anything. I had to push for her to prescribe Urso, and to also do the NSTs since we were already doing monthly biophysical profile scans. After showing her the research behind Cholestasis of Pregnancy, and what ICP Care website shows, she agreed and placed me on Urso, along with the biophysical profiles. However, she refused to induce at 36 weeks citing it was too early.

I was again induced – this time at 37 weeks, because of how miserable I was. I was itching so bad that I had gashes on my arms, hands, feet, stomach and was bleeding.

My induction started around 9:00am, and my doula came around 12:00pm, and she helped me get through the worse contractions ever (Pitocin is evil ha-ha) by dancing with my husband. She even braided my hair. She truly was the best. But my son didn’t want to wait to come. He was born at 2:59pm on what they’re calling a record induction. He was 5lbs 11oz, and severely jaundiced. He also came out so fast, that he swallowed amniotic fluid, and was not breathing — that was the scariest moment of my life! Once they got him crying, I relaxed some.

After my son was born, I did follow up with my Hepatologist, who told me that my gallbladder needed to come out. I had a cholecystectomy in May 2022, a year after he was born. Fortunately, the only issue I’ve had since my son’s births relating to my liver is related to my NASH/Mitochondrial Hepatopathy.

After attending GLI (Global Liver Institute) A3 (Advanced Advocacy Academy) in Washington DC in September 2023, and having the pleasure to meet Donna and her team, I decided that with my advocacy experience, and my passion for making a difference that I wanted to be on the team of ICP Care!

I am currently involved in many organizations in advocacy and community service. I am Mental Health First Aid Certified, am an Advanced Advocacy Academy Graduate, I Have attended GenIX Advocacy, Mentorship and Leadership Programs, I have been involved in the congenital heart disease community passing proclamations for CHD Awareness Week in my county, I am involved in the Ohio Bleeding Disorders Council as an Advocate who attends “state house” day where I talk about copay assistance programs, prior authorizations and insurance, I am an Ambassador with Global Liver Institute serving on several committees. I am on the Global Patient Advisory Board for NASH at Boegringer-Inhelheim, I am on the Policy Council Board at Crossroads Early Headstart.

I’m very excited to join the ICP Care team and help raise awareness, connect, and educate people about cholestasis during pregnancy and more importantly – to help advocate. To be a voice for those who are afraid to speak up. To raise awareness of this rare disease that no one speaks about. To help others be aware that ‘just an itch’ may not only be an itch.

I look forward to bringing my advocacy experience, compassion, and drive/desire to make a difference in this world to the ICP Care team!