In 2009, a few months after my first child had been born, I bumped into my friend Rachel in the supermarket. The conversation immediately turned to Rachel’s current, quite far along pregnancy; which was proving to be difficult for her after having been recently diagnosed with the rare liver condition, cholestasis of pregnancy. While discussing this condition, Rachel quickly shoved her intended purchases underneath her arm, and scratched anxiously in between her fingers.
She continued to tell me about the scratch marks all over her arms, the nights spent scratching her feet to bits at odd hours, and the itchiness in her ear drums. Her feet were covered in welts, her fingers were covered in scratch marks, and Rachel was in the supermarket searching for a cold pack to ease the itch when it worsened later that night.
Cholestasis of pregnancy presents itself in the last trimester of one’s pregnancy, and is so rare in fact, that only one in one thousand women will be unfortunate enough to suffer with this condition.
That conversation with my friend was a moment in time sent to me by the universe, a pure coincidence, and a conversation that would equip me with the knowledge to self – diagnose.
In 2010, I fell pregnant again, this time, with a little boy. It was another difficult pregnancy, and one which would be endured again with hyperemesis Gravadarim – an illness which has been the bane of my pregnancies. This time though, for my second pregnancy, I would go to the naturopath to ease my symptoms. At the heart of this pregnancy illness, was a faulty gallbladder which was making me sick. My gallbladder simply couldn’t process bile quickly enough.
The naturopath advised me to go on what would be a very stringent diet; one which would eliminate all unnatural fats. The fact that all fats had to be natural is the very reason why I became so taken with sanitarium peanut butter. I craved peanut butter all day and all night. I ate jars of the stuff – and it was my absolute go to for breakfast, lunch and dinner.
At about 6.5 months pregnant I suddenly began to feel itchy almost everywhere. I was itchy on my feet, my hands, in between my toes, fingers, all over my legs, and even inside of my ear drums. I was so terribly itchy that I often cried over the fact. Night-time was a time to scratch, and to scratch for hours at a time. I had scratch marks on my legs, all over my stomach, underneath my feet, in between my toes, on top of my toes, and all over my arms. My entire body was itchy. I spent my days scratching and clearing my throat to try to stop the itching inside of my eardrums – and I couldn’t stand it.
I would scratch for hours in between my fingers, in between my toes, and both on top of, and underneath my feet. I tried soothing the itching with bags of frozen peas, and cold packs; anything and everything to stop the itching.
I did everything I could to relieve this terrible condition. I even went in search of ocean air, and the deep blue sea, believing somehow that my chronically itchy skin would be deeply soothed once in the ocean. I travelled to Bondi Beach – and waddled in amongst all the beauties, round as a ball, all scratched up, and itchy as one can be. Refraining from scratching myself in public places was a difficult feat. I waddled onto the beach, and dipped my scratched up body into the ocean, hoping it would soothe my chronically itchy body. I looked like I had been five rounds in a boxing match, and nothing helped ease this problem.
What I didn’t realise at the time is that bile salts from my faulty gallbladder had spilled over from my liver into my bloodstream – and I literally had salt penetrating into my skin. No wonder I was so itchy.
Five weeks before I was due to give birth, I went to the doctor for my monthly pregnancy checkup. The doctor confirmed that everything was fine. Just before I was due to leave, the doctor asked me if I had any worries or concerns. I was about to get up and leave; when it occurred to me that just maybe I should mention my never-ending itch, especially in consideration of the knowledge my friend had alerted me to that night in the supermarket. I proceeded to tell the doctor about this odd illness that I thought I knew I didn’t have. He immediately organised a blood test, and told me that my itching was a big concern.
Within one week it was confirmed that I was suffering from cholestasis of pregnancy. At 37 and a half weeks pregnant I was induced. The doctor’s were very concerned for my baby’s life.
What is cholestasis of pregnancy?
Cholestasis of pregnancy is a rare liver disease confined to pregnancy, which occurs in the last trimester of pregnancy. The normal flow of bile in the gallbladder becomes affected by high levels of pregnancy hormones. Pregnancy hormones affect gallbladder function, resulting in these hormones either slowing down, or sometimes completely stopping the flow of bile. The gallbladder holds the bile originally produced in the liver. Bile is a requirement in the breakdown of fats during the digestion process. If bile flow either stops, or slows down, bile acids will build up in the liver. The consequences of bile build up in the liver, is that the bile will ultimately spill over into the bloodstream.
Bile salts will normally flow with ease from a person’s gallbladder into the digestive tract. During pregnancy, high levels of hormones often interrupt this natural process. The bile instead transfers too slowly, and the bile salts than build up in the liver and spill out into the bloodstream. Instead of these salts being directed to the gut, they will instead be deposited underneath the skin.
How will the baby be affected if the mother is diagnosed with cholestasis of pregnancy?
Cholestasis often increases the risks for fetal distress, premature birth, or stillbirth. An unborn baby relies heavily on their mother’s liver to remove bile acids from the blood. Heightened levels of bile spilling over from the mother’s liver into the mother’s bloodstream can cause stress on the baby’s liver. Women with cholestasis of pregnancy are usually monitored closely, and serious consideration is often given to inducing labor once the baby’s lungs have reached maturity.
What to do?
After a cholestasis diagnosis, it is highly likely that if you choose to become pregnant again, this rare liver disease will return in the third trimester if you don’t take precautions to eliminate the likelihood. For me personally, I am a big fan of the naturopath or homeopath; both of which have helped ease my gallbladder, and liver problems during pregnancy.
A good homeopath can tell you what will work exclusively for your body, and how to rid cholestasis symptoms. My homeopath gave me some very safe pregnancy advice, which enabled me to have a cholestasis free experience for my third pregnancy.
I personally was advised to drink a lot of dandelion tea. Dandelion tea is apparently very cleansing for the liver. I was also advised to stay away from peanut butter, to cook everything in olive oil, conduct a gallbladder cleanse with naturopathic herbs, to stay away from chips, sausage rolls, and savoury foods. These remedy’s kept me free of cholestasis symptoms. High fat content makes it very difficult for the gallbladder to process bile, which in turn leads to an overflow of bile salts into the liver itself.
These dietary requirements worked for me and kept my baby safe. That being said, everybody’s body is different, and what may work for some people, may not work for others. What may be safe for one pregnant person may not be advised for another pregnant woman. Its always best to check with your own naturopath.