You are pregnant and all the wonderful changes that happen to your body during pregnancy are happening to you. Your hair is thick and glossy, your nails have never been stronger, your face has that slightly flushed glow to it, your lips are plump and you are simply glowing…right?
Ok, maybe not. What you may have noticed is that your skin is tight and you have a slight itch. Over time this itch has spread all over your skin, it’s an itch that gets worse day by day. And. Now. It. Won’t. Go. Away.
As your baby grows so too does your tummy. With this growth the skin around your abdomen, hips and lower back gets tight. It’s 100% normal for your skin to become itchy during this stretching phase. The good news is there are a few things you can do to lessen the irritation.
The most effective treatment for an itchy belly is a natural moisturiser, something with calamine that works well. Applying a moisturiser morning and night can help hydrate your skin and will significantly help the itching. Using a moisturiser that is as natural as possible is a must. Remember your skin is your biggest organ and anything applied topically enters your bloodstream. Your little human is sharing your blood so limit the toxins.
Try to wear natural materials such as cotton. It is breathable and will help your skin to regulate temperature much easier than wearing synthetics. Lycra can be an irritant. So, no active wear, or at least try not to stay in it all day. While we are on the topic of activewear, anything tight and restricting can also irritate already itchy skin. Wear loose-fitting clothes to reduce the itch.
Try to avoid hot and humid conditions as this too can irritate your already sensitive skin.
So, this is all helpful information but what happens when the itch become unbearable and localises to your hands and feet? This may actually be a medical condition that can become deadly to your baby. It needs to be diagnosed and needs to be monitored.
Read on my friend…
Obstetric Cholestasis is a liver condition that affects 1 in 100 pregnant women. It has varying degrees of severity. Bile is produced in the liver and usually flows down the bile ducts into the intestines where they help with the digestion of food. In Obstetric Cholestasis, the flow of bile into the intestines is reduced and you end up with a build of bile salts in your blood. The increase in bile salts is the cause of the itchiness. This can be worse at night, which can consequently cause insomnia and fatigue in the sufferer.
Generally, the itch is worse on the hands and feet but can be over the whole body. For some women, the itch can be so desperate that they scratch until they bleed. Less commonly, women may develop jaundice.
So how is Obstetric Cholestasis diagnosed and what can be done?
If you experience itching, generally in the last 10 weeks of pregnancy it’s important you tell your midwife or doctor. They will consider Obstetric Cholestasis as a diagnosis based on your symptoms. A blood test will check the function of your liver and help with the diagnosis. Sometimes this test will come back negative so will need to be repeated. If it is positive the test will most likely be repeated at different stages for monitoring.
Your doctor may also order an ultrasound to look for gallstones, which could be the reason for the blockage of bile into the gut. Gallstones are rare in pregnant women but it is possible to have both Obstetric Cholestasis and gallstones.
If you are diagnosed with Obstetric Cholestasis you will be closely monitored during your pregnancy. There are also two drugs that are commonly used to help treat Obstetric Cholestasis called ‘Ursodeoxycholic acid’ and a steroids such as ‘dexamethasone’. Your doctor will discuss this with you.
So why is it important to be monitored and potentially treated?
Although extremely irritating, Obstetric Cholestasis causes no harm to the mother. However, it is potentially life threatening to your baby. There is a 15% higher risk of your baby being stillborn. The reason for this is still unknown but some believe it is either due to placenta problems or due to the bile acids crossing the placenta. Either way, it is avoidable so listen to your doctor’s advice.
There is an increased chance that your midwife or doctor will suggest inducing you. Depending on the severity of the Obstetric Cholestasis will depend on how long they will leave baby to grow. They will weigh up the odds of having a potential stillbirth with the risks associated with a premature delivery.
Although this sounds grim, severe Obstetric Cholestasis is rare. The majority of the time women are monitored and treated and go on to have full-term healthy babies.
What will happen after your baby is born?
Like all newborns, your baby will be offered a vitamin K injection. This will protect your baby from bleeding. Although this is not compulsory, speak to your midwife or doctor about the pros and cons of having this.
It is very important for you to have a blood test at about 6-12 weeks after you have had your baby to check your liver function.
The good news is, the itching will naturally decrease and be totally gone about two weeks after having the baby.
And as always, be kind to yourself, you are doing the best job you can!
