Birth of your baby
Your baby can be born vaginally.
- There is no evidence to show that it is safer for your baby to be born by Caesarean section (c-section), but as you may need to meet your baby earlier you are likely to be induced. As with any first-time mother-to-be, this means induction may not work and your risk of having to have a c-section increases.
- Your doctors may decide that your baby will need to be continually monitored during labour, although there has been no research to suggest that this is necessary. Talk to your consultant about what you both feel is best for your and your baby. Bear in mind that ICP still carries a risk of fetal distress during labour, which, if your bile acid levels are over 100 µmol/L, might help you make a decision about what is the safest option for your baby.
- Having an early baby can be a worrying time for you, especially if your baby decides to come without giving you much notice! But if you do know that your baby may have to spend some time in a special unit (referred to as a neonatal intensive care unit (NICU), neonatal unit (NNU) or special care baby unit (SCBU)) you can ask to be shown round the ward so that you can prepare yourself. It can look quite overwhelming when you first see it: lots of machines and monitors, and some very tiny babies. Many parents have been in this situation and are very happy to talk to you about their experiences, so come and find us on Facebook, where we will be waiting to support you.
- Your baby will not need any special checks after the birth, but you should have a liver function test and your bile acids checked around 6–12 weeks following your baby's birth.
It is important that you know that because ICP is a genetic condition your baby may have inherited your genetic changes. This may mean that if you have a girl she has around a 14% chance of ICP in any pregnancy that she may have. If you have a boy, he may pass the gentic change down to his children. There is also some suggestion that children of ICP women have a slightly increased risk of developing Type 2 diabetes in later life. This is still being researched.
Ovadia C, Seed PT, Sklavounos A, Geenes V, Di Illio C, Chambers J et al. Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses. The Lancet 2019; DOI: http://dx.doi.org/10.1016/S0140-6736(18)31877-4.
Ovadia C, Williamson C. Intrahepatic cholestasis of pregnancy: recent advances. Clin Dermatol 2016; 34: 327–34.