Pregnancy Comes In All Shapes And Sizes: Cholestasis with Our FairyTale Adventure
Itching is commonplace in pregnancy. Usually it’s mild and causes no harm to the baby. Sometimes it can be due to hormones and later on, as bump grows, the skin of your abdomen becomes stretched and this may also feel itchy.
However, itching can be a symptom of a liver condition called intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis (OC). It is diagnosed by a series of blood tests.
ICP needs medical attention. It affects 1 in 140 pregnant women in the UK, around 5,500 a year. ICP can possibly cause complications such as stillbirth. The symptoms can often be managed with medication during pregnancy but ICP only resolves once the baby is born. Most mums with ICP will go on to have a healthy baby. Mums with ICP do need close weekly monitoring and in some cases need early induction at around 37 weeks. For more information on ICP please see the links at the bottom.
Please tell us a little bit about your family.
I’m Emma and I write the parenting and lifestyle blog ‘Our Fairytale Adventure’, which is about life with my partner Mr. C and our two boys Bear and Monkey. There is only 17 months between them, so life can get a bit hectic sometimes.
What symptoms did you have that made the midwives/doctors suspicious of cholestasis?
I was in the last trimester of my pregnancy with Bear when my bump started to become incredibly itchy. I was being monitored weekly anyway because I had polyhydramnios (excess water), so my bump was already measuring bigger than what it should had been and the doctors told me it was normal as the skin was stretching to accommodate my baby. I wasn’t convinced it was that though, so I was given a blood test that showed my salt levels were slightly higher than they should be but was told there was nothing to worry about and was sent on my way.
How many weeks pregnant were you when you were diagnosed with cholestasis?
My bump continued to be really itchy and was getting worse as the weeks went on, I kept mentioning it and it kept being ignored. It got really bad, to the point where I spent a lot of my day in the bathtub and had cold flannels on my bump during the night to help ease the itching. Eventually I demanded another blood test at about 36 and a half weeks and the results came back that I had cholestasis, I was put on some medication to help control it and was booked in for an induction a week later.
Did you feel well supported by the healthcare team?
Not really to be honest. I know it is a relatively rare condition but I was made to feel like a complete hypochondriac, when in reality I had a condition that if left may have resulted in the death of my son before he had even arrived in the world.
How did you feel mentally and physically whilst coping with cholestasis?
I found it really upsetting that nobody listened to me. I think we all know our own bodies best and I knew something wasn’t right. I took the whole thing in my stride while I was pregnant though, it was only after Bear had arrived that it hit me that if I didn’t demand that blood test, the outcome of my pregnancy with Bear may have been a very different and if I’m honest that really affected me mentally.
How did you feel about all the extra monitoring?
I was already being monitored anyway because of the polyhydramnios and I quite liked hearing Bear’s heartbeat, it reassured me that he was okay. Mr. C came with me to the appointments, which my in-laws felt was unnecessary and a waste of his time. We were renovating our house at the time and were staying with his parents, we actually moved into our house early and while the renovations were ongoing because of it. So in that sense it put a lot of pressure on our relationship, which was a quite stressful.
Did cholestasis impact on your birth choices?
I wanted a holistic water birth, but as I had to be induced and monitored I was strapped to a machine and unable to move around. I ended up being in labour with eye watering contractions for nearly 24 hours and ended up taking every drug they had. The birth itself was quite traumatising to be honest. Bear’s heartrate dropped during labour and I ended up having a forceps delivery. After Bear had been delivered I lost a bit of blood and the drs were worried I has haemorrhaged, so were forcing a lot of weight onto my stomach, which was excruciatingly painful. Thankfully I hadn’t and both Bear and I are here and we are fine, but the whole experience made me very anxious during my pregnancy with Monkey. I was terrified something would go wrong and found it very mentally taxing.
If you’ve had another baby since did you suffer with cholestasis again?
I did have cholestasis again. I started getting really itchy hands and feet about 37 weeks the second time around. The doctors weren’t too worried. They said as the symptoms differed from my first pregnancy it probably wasn’t cholestasis. I knew there was a high risk of me developing the condition again as I had already experienced it in my first pregnancy, but the doctor I saw wasn’t actually aware of this. I had some blood taken, I had to chase the surgery for a few days to get the results, which showed my salt levels were a little high. Again I was told not to worry and sent on my way. The next day I was sat in the bathtub crying at about 1am because my skin was itchy and we ended up going to the labour ward. I had bloods taken again and was told my levels were very dangerously high and they would be inducing me immediately. Monkey was born that same day.
How are you now?
To be honest it really affected me. It’s quite upsetting knowing my body can’t protect my babies. We initially talked about having three children close together, but after my last pregnancy have decided to stick at two for now and see how things are in a few years. I don’t think I’m mentally capable of another pregnancy after the two difficult pregnancies and labours. I think I took pregnancy, an easy labour and a healthy mum and baby afterwards as a given. The experience has definitely made me realise that isn’t the case and I think (if possible) it has made me cherish my children even more.
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If you are worried about itching you are experiencing during pregnancy then please, please discuss with your midwife or your GP. If the itching continues after a normal blood test then please go back to your midwife. ICP is more common after 28 weeks of pregnancy but unknown before.