Moved over to main website blog: Obstetric Cholestasis

Obstetric cholestasis

It has a number of names : Intrahepatic cholestasis of pregnancy (ICP), obstetric cholestasis, cholestasis of pregnancy, jaundice of pregnancy, and prurigo gravidarum.

What is it?

Obstetric cholestasis is a disorder that affects your liver during pregnancy. The main symptom is itching on the palm of your hands or soles of your feet. Another symptom is persistent itching of the skin (anywhere on the body) when there is no skin rash.

How common is it?

Takes from the RCOG : Obstetric cholestasis is uncommon. In the UK, it affects about 7 in 1000 women (less than 1%). Obstetric cholestasis is more common among women of Indian- Asian or Pakistani-Asian origin, with 15 in 1000 women (1.5%) affected.

Iching is a really common part of pregnancy, caused by the stretching of skin as your body accommodates your growing baby/babies. However, it can be one of the warning signs of cholestasis. It is important to flag any concerns with your care provider (midwife or obstetrician). They can preform a simple blood test to rule out any concerns of cholestasis. 

So what happens if you are diagnosed with obstetric cholestasis? 

Once diagnosed with obstetric cholestasis, you will be advised to be under the care of a consultant and have your baby in hospital with a neonatal unit (NICU). 

There is no cure for obstetric cholestasis but all symptoms generally disappear once your baby is born.

Most women will then have additional antenatal checks. This will include regular liver function tests, until you have had your baby. You will also be offered additional monitoring of your baby. Often this will involve extra ultrasound scans checking growth and measuring the amount of fluid around your baby.

When you are in labour, you will be offered continuous monitoring of your baby’s heart rate. There is some evidence that it is safer to birth your baby early if your symptoms are severe. You will have an opportunity to discuss the option of having labour induced after 37 weeks. 

Early induction (before term, 37 weeks) may carry an increased chance of having interventions such as assisted birth (forceps etc) or having a caesarean birth. It also carries an increased chance of your baby being admitted to the special care baby unit (SCBU) with complications of preterm birth. Your care provider or obstetrician will discuss what they feel is best for you and your baby in your individual situation so that you can make an informed choice.

Remember to take time to ask lots of questions. It can be helpful to have a notebook and pen ready to take notes as in unexpected situations it can be hard to take in all the medical information you are being told. 

Take time to weigh up all the pros and cons and understand each step before making your informed decision. 

Our doulas are an amazing support through this process - walking the journey with you - offering emotional and physical support. If you would like more information on how we can best support you pop us an email on info@doulacare.ie 

On our children birthdays

On the anniversary of your babies birth 

Every year as the days approach my children birthdays, I find myself reliving where I was and what I was doing the year they were born. Particularly the 24 hours just before. My eldest boy is twelve. If anything, as the years pass these days seem even more special. Reliving their births and remembering how wonderful it was to be pregnant with them, adds a sentimental value to their birthday beyond celebrating their life so far. 

I wake up the day before thinking ‘This day twelve years ago, I woke up for the last time before I would be changed forever and become a mother.’ I had no idea the impact the next 24 hours would have on me or how my life would change forever - my soul tied to another - who shared my body and grew from love.

How did the years move so quickly? Twelve years of mothering. Buying a house. Studying. Working. Taking trips. Having more babies. First days of school. Ferrying kids to a from sports and activities. Family meals. Endless loads of laundry. Play dates. Baby groups. Parent teacher meetings. School events. More laundry. 

I look at the clock randomly and think : ‘11am, this time twelve years ago I was just getting on the DART with my cup of tea to go in for my 41 week hospital check.. Rubbing my big bump. Feeling my baby kick. Wondering what he will look like’

I look at my beautiful boy and wonder again where the years have gone. He is almost as tall as me now. Yet I can still feel his tiny newborn body snuggled up to me. How it felt to kiss his soft cheeks. That gorgeous baby smell as I sniffed his tiny head with wisps of hair. The absolute joy I felt breastfeeding him. That glorious bond of mother and baby, in our own little bubble of calm. 

‘3pm, I was making my way to that cafe for a smoothie. I was feeling uncomfortable. Little did I know, I was in early labour and a few hours later I would be heading back to the hospital to give birth.’ 

I still get hugs. Sometimes (once his friends are not around) Kisses are restricted to a peck on the cheek. The hormones are running through his body. Bouncing him from my boy to a young man. Regular melt downs. Slamming of doors. Change is happening. 

‘11pm, in the car on the way into hospital. Excited to meet my baby but fearful of what was to come’

My seven year old comes bouncing in and kisses his baby sister. Before I know it, he will be at this stage. No longer jumping on me for big sloppy kisses and a massive squeeze of a hug. Enjoy this time now I remind myself. The days seem endless sometimes, but the years seem to fly by in a flash. 

‘8.08am, my world shifts a gear forever. I am someones mama. This perfect, tiny, human is mine. Image of his dad of course. Surrounded by love. Filling my heart to bursting point’

Me with my first son seth in 2007 (at the tender age of twenty)

As we all sit around the kitchen table singing happy birthday. My handsome boy blushes. He is embarrassed by the fuss now. I am grateful for the memories. Some hard. Some challenging for sure. Overall as I remember my experiences of motherhood, I am filled with love. It is not always perfect. Nothing is, right? But I wouldn’t change any of it. My children are my world and I love celebrating each journey into motherhood, with each individual experience - once a year. 

So to all the mothers out there on your Childs birthday. Happy Birth Day memories to you too. Your strength, love and power got you through and will continue to do so as the years fly by. Take a moment to remember. Maybe every now and then you can pause and relive your experience too.

My first born son Seth, about to embark on the teen years. Photo credit @JohannaKingPhotography