My name is Ashley Bonnes, I am the Illinois Ambassador for ICP Care. My ICP story started in 2018, while pregnant with our son. I’d just been diagnosed with gestational diabetes at 28 weeks. Only 2 weeks later, I first felt itching at 30 weeks while traveling. Worried it might be bed bugs, I ripped back the sheets but didn’t see anything. So, I looked up my symptoms online, and learned about intrahepatic cholestasis of pregnancy. I told myself I’d call my doctor when I got home, but the itching stopped.

About three weeks later I felt the itching again, and this time I sent a message to my care team right away. They had me come in immediately to get tested. While waiting for my results, at 33 weeks and 5 days I went into labor for the first time. Fortunately, they were able to stop it, and gave me steroids and surfactant to help our baby. It was while I was in the hospital that I received the positive results for ICP with bile acid levels of 107. I was put on bed rest until my scheduled induction at 37 weeks.

I didn’t make it that long though. I went into labor again, and delivered our son at 35 weeks and 3 days. His birth was fast and furious. I’d been constipated since first going into labor, and thought the sharp pain I was experiencing was a result of that. When I saw some blood, we made the decision to go to the hospital. When I got there, I found out I was fully dilated and had to deliver right away. Our son’s heart rate was high, so they wanted him out fast – no time for an epidural! His shoulder was stuck so I had to have an episiotomy. When he was born there was concern of meconium aspiration, but we were lucky. He turned out to be just fine. They observed him in the nursery for the required 8 hours, but he didn’t need to be in the NICU. I, on the other hand, had retained placenta, ended up with severe postpartum hemorrhaging, and had to have a D&C.

Fast forward four and a half years, I was pregnant with our daughter. My doctor was very conscientious and decided to partner with a team of high-risk maternal fetal medicine (MFM) doctors. I had increased testing and observation throughout my pregnancy. I tested for gestational diabetes early, and again at 28 week – negative both times. I made it past 30 weeks with no itching and was cautiously optimistic. However, the likelihood of getting cholestasis again was upward of 90% after such a severe case. Then at 31.5 weeks we decided to take our son for a weekend getaway. After swimming in the hotel pool, the bottom of my feet were slightly itchy. I was hoping it was a reaction to the chlorine but playing it safe, I asked my doctor to test my bile acids that Monday – he, of course, agreed. The itching didn’t persist, and the results came back negative at only 0.1. (Sigh of relief).

At 35 weeks I came down with Covid-19, and less than a week later the itching started. It was bad, itching on my hands and feet. I called my doctor and let him know, so we tested again. This time the results came back at 22. 22 is much less severe than the 109 in my previous pregnancy, but still a positive result that required early delivery. We scheduled to induce labor and delivery at 37.5 weeks. I took Benadryl to help with the itching until it was time to deliver. When it was time to be induced, everything went extraordinarily smoothly. It was truly a night and day difference from my first birth experience. I am so incredibly grateful that I had support from ICP Care, and an amazing team of medical professionals that took cholestasis so seriously.

My two children and I are doing well now, and so far, have had no lingering effects – thankfully.

My goal as an ICP Care Ambassador is to help prevent traumatic experiences for others. This is a condition I had no idea about, and it has such serious effects for mom and baby. I want to do what I can to help others that may end up in the same situation.