Case study

Leah Beller opted for a c-section at 35 weeks because there was no way of knowing if her bile acid levels were spiking and putting her baby at increased risk.

‘I was diagnosed with intrahepatic cholestasis of pregnancy (ICP) at 32 weeks when the itchiness, which started on my feet, spread all over my body.

‘My husband thought I was jumping the gun when I said what I thought it was after reading about ICP online. But I knew deep down that I had it.’

‘We need to fight for a quick return on bile acid results in all hospitals. I had to wait for up to five days for mine, which meant having my son earlier than I’d hoped.’

Unfortunately, where Leah lives in Qatar, it can take up to five days to get the bile acid test back – the test needed to confirm her ICP diagnosis, which eventually came back at a level of 19.

‘I started having weekly tests to monitor my levels, and my son was breech, so the plan was to try and turn him at 36 weeks and then induce. However my liver function skyrocketed, and because we couldn’t get the bile acids back quickly, my doctor said we were playing with fire as we had no way of knowing if my levels had gone over 100 (which has increased risk for the baby). So we opted for a section.’

Leah was keen to not worry her family so tried to stay as calm as she could after her diagnosis. ‘I had a few moments of freaking out but my family were already upset about not being with me because of the pandemic. So I tried to keep it all together and did a lot of reading so I could have good discussions with my doctors. All the feelings came out after he was born and I was a lot more emotional then.

The hardest bit was two days after my son was born and I was laid up in bed recovering, unable to pick up my son and feed him. I asked the nurses to let me know my bile acid result, taken just before the birth. And it turned out they had gone back down, and not spiked as we feared, so we could have waited and not had the baby so early, if only we’d known.’

‘Having an organisation I trusted like ICP Support, and a place where I could do my own research, made a big difference.’

Leah also found it hard there were no clear-cut answers to begin with. ‘My doctor told me there was no consensus in the medical community about how to treat cholestasis. So having an organisation I trusted like ICP Support, and a place where I could do my own research, made a big difference. I’m now a moderator on the ICP Support Facebook group myself, so I can help other women get access to clear, evidence-based information about the condition.

‘My hope for the future? That bile acids can be available everywhere within 24 hours, so that babies don’t have to be born so early, in line with Dr Ovadia’s study.’

If this story resonates with you because you have experienced a stillbirth, you are very welcome to join our Facebook Precious Memories Group or our general ICP Support Facebook Group. You might also like to call the ICP Support helpline to talk things through.