Most women know that with pregnancy comes many changes to their body. Classics are insatiable hunger, swelling, mood swings, weight gain and stretch marks. A little less known symptom, one which usually turns up in the second or third trimester, is itching.
Itching can be caused by more than one thing and can turn up in more than one place. However, most often, it occurs on the belly and the cause is from the skin stretching. Lotions and oils can help relieve itching, possibly even help prevent stretch marks, but that’s up for debate. Some believe stretch marks are hereditary and no amount of lotion will help. I say it can’t hurt so you’ve got nothing to lose putting it on. I recommend coconut oil. A large jar usually runs between $15 and $20, however you need such a small amount and the bonus is since it’s natural, there’s no added alcohol like there are in many lotions, which is counter productive.
Another cause of itching during pregnancy is PUPPS (sometimes referred to as PUPPP or PEP). PUPPS is short for pruritic urticarial papules and plaques of pregnancy. It’s a rash that starts on the stomach that consists of small, itchy, red bumps similar to hives. It can spread to the entire body, save the face, but doesn’t always. PUPPS also occurs during the second or third trimester and in most cases doesn’t resolve until shortly after birth, generally one or two weeks. Treatment can include prescribed ointments or antihistamine tablets. Some women find relief with pine tar soap. In some cases, the itching can be so unbearable for the mother that labor is induced at 37 weeks when the baby is no longer considered premature.
Although PUPPS is said to only resolve after birth and also that treatment is only able to relieve symptoms, I believe there may be some exception. I strongly believe I developed PUPPS during my pregnancy with my middle child; I developed spots like hives all over my body and they itched so much that I was making the skin raw, I had difficulty falling asleep because the rash seemed to be more itchy in the evening. This lasted for a few weeks. However, it was never diagnosed by my physician because before I could mention it to him at my next appointment, the rash went away. The only change I made was washing the bed sheets because we thought maybe it was something to do with the sheets (I hadn’t used a new detergent or fabric softener) since it was only happening at night. Low and behold it seemed to solve the problem. I know it’s not typical of PUPPS, but everything about my symptoms felt like it was.
A much less heard of condition which can cause itching is cholestasis of pregnancy. Some doctors are not very familiar with this condition since it is so uncommon. Cholestasis of pregnancy is a condition in which the normal flow of bile in the gallbladder is affected by the high amounts of pregnancy hormones. Cholestasis symptoms include loss of appetite, fatigue or exhaustion, dark urine, light color bowel movements, and itching, particularly on the hands and feet (this is sometimes the only noticed symptom). Less common symptoms can include jaundice, nausea and upper-right quadrant pain.
When I was in my third trimester with my youngest child, I woke up one morning and my palms were itchy. I had been itchy on my forearms as well and just assumed it was normal pregnancy itching at first, but when my palms became itchy, I thought it was strange. I decided to Google “pregnant itchy arms and hands” and I got hits for cholestasis. I made the connection that I probably had cholestasis after reading the symptoms list and it clicked that I had been having lighter colored bowel movements as well (TMI, sorry, but relevant).
The symptoms that present with cholestasis are not very alarming, however cholestasis is potentially dangerous to the fetus and it is very important to get a diagnosis as soon as you suspect you may have this condition. Cholestasis may increase the risks for fetal distress, preterm birth, or stillbirth. A baby relies on the mother’s liver to remove bile acids from the blood, therefore, the elevated levels of bile cause stress on the baby’s liver. Women with cholestasis should be monitored closely. Doctor’s can prescribe medication to alleviate the itching and also to reduce the bile levels. Additional ultrasounds may also be ordered.
The only cure for cholestasis is giving birth, but there are some things you can do to make yourself more comfortable:
- The itching can be worse if you’re stressed, so try to stay relaxed.
- The itching can be worse at night, making it difficult to sleep, so try to get rest whenever possible.
- Try to avoid fatty foods and eat healthy.
- Avoid alcohol as it can affect your liver (this doesn’t apply to everyone, but some women choose to enjoy a drink now and again).
- Wear light, loose cotton clothes.
- Take cool baths.
- (Lotions don’t help since the itching is not an external issue.)
The sooner you catch this, the better. Don’t ignore your body and pay attention to changes. The health of you and your baby are the most important thing during this time, so it’s better to check with your doctor than to ignore.
Around the time my daughter turned 9 months old, I started experiencing itching again and also lighter bowel movements. I have read that after having Cholestasis during pregnancy, it is possible to have liver issues after giving birth. When my daughter was newborn, we rechecked my liver function and it showed my bile levels had returned to normal. We checked my levels again around the time she was 11 months after I was having the same symptoms and again my levels were normal. I was so convinced my liver was out of sorts again. I am vigilant on keeping mental notes as to how often I’m itching or having any other symptoms due to the fact it could become an issue again.
I have also read many message boards where mothers have said the itching returned shortly after birth, or like me, sometimes months after. Most of the women said their liver test levels showed normal however. I am wondering if I’m just more hyper-aware of itching and possibly over thinking what I think are symptoms or if there’s some kind of phantom symptom phenomenon that’s occurring postpartum.
Cholestasis seems to be a bit mystifying. Hopefully as time passes, there is more information about this condition both during pregnancy and after.
Have you or anyone you know had itching during pregnancy? Was it Cholestasis or something else?