- Late in my pregnancy, my feet and hands started itching, and nothing gave me relief.
- I recognized it as intrahepatic cholestasis, which can increase the risk of stillbirth.
- I got a prescription to help with the itching, then scheduled an induction.
When I got pregnant with my daughter, I essentially made reading about pregnancy a part-time job. I read a couple of the typical books, but I also devoured websites and forums for hours on end.
Most of my pregnancy was fairly typical. I had constant first-trimester nausea and heartburn, and I experienced all the ups and downs of the second trimester. By the end of the third trimester I was grumpy, sore, and exhausted. I felt like a squirrel was tap-dancing on my bladder and throwing jazz hands into my ribs. You know, the usual.
One night, around 38 weeks into my pregnancy, I absentmindedly scratched an itchy spot on the bottom of my foot. It kept itching, but I didn't think much of it.
The itch spread over my feet and to my palms, and scratching did nothing to relieve the torment.
Nothing eased my itch
Pregnancy comes with a host of dermatological annoyances such as dry skin, PUPPP, and melasma, but this itch left me wanting to amputate parts of my body. I tried oral antihistamines and various creams, which provided the same amount of help as scratching — none at all — though at least the antihistamines helped me get some sleep.
There was no visible rash, but I woke up the next morning having scratched my feet and hands raw. Over a couple of days it spread to my legs and arms.
From my semi-obsessive reading, I recognized this sort of itch that won't quit as the major indicator of intrahepatic cholestasis, more commonly known as cholestasis of pregnancy or ICP. Other symptoms can include pale poop (which I had, though at the time I attributed it to a stomach bug), dark urine, right-upper-quadrant pain, and jaundice. Others are harder to distinguish from regular pregnancy symptoms: mild depression, fatigue, and nausea.
I made an appointment with my midwives. They agreed with my suspicion and ordered bloodwork to find out for sure. They also wrote me a prescription for a medication that helped with the itching.
When the bloodwork showed ICP, my inner anxious voice felt validated, while the rest of me felt very scared.
Cholestasis can increase the risk of stillbirth
Though it is not generally associated with increased maternal mortality, ICP can increase the risk of stillbirth.
We scheduled a hospital induction, giving me a few days to try various at-home labor-inducing tricks.
I scheduled acupuncture, had daily cervical sweeps, and drank castor oil — with my provider's blessing. The castor oil led to an evening of light contractions, but by the time we headed to the hospital the next morning they had tapered off.
I was disappointed to lose out on the chance to have my baby at the local birth center but was relieved that one of the midwives from that practice would be with me through the induction.
From that point on the induction was pretty straightforward, and the next day my healthy daughter was born.
It's been 12 years, but my brain sometimes uses that incident to feed the anxiety monster as I doomscroll WebMD. I use those moments to remember that anxiety is the ultimate frenemy: It tries to help but has poor boundaries. And just because it was useful once doesn't mean I have to listen to it every time.
But I'm glad I listened to it that time.