How to Cope with Cholestasis of Pregnancy

Suffering from cholestasis or itch-related complications? Learn remedies, treatments and tips about coping with cholestasis of pregnancy.

Cholestasis of PregnancyIf I could have called it quits during my pregnancy with the twins, I would’ve done it any time around the 32-week mark.

You see, a woman carrying twins at 32 weeks is already as large as a woman carrying a singleton at 40 weeks. In other words, twin moms are ready to pop but still have to grow for two more months. Not fun.

And, as if I couldn’t get more uncomfortable with my size, I got hit with a diagnosis of obstetric cholestasis.

What is cholestasis of pregnancy?

Few people know about cholestasis, including myself at that time. The Mayo Clinic says:

“Cholestasis of pregnancy occurs in late pregnancy and triggers intense itching, usually on the hands and feet but often on many other parts of the body.

Cholestasis of pregnancy can make you intensely uncomfortable but poses no long-term risk to an expectant mother. For a developing baby, however, cholestasis of pregnancy can be dangerous. Doctors usually recommend early delivery.”

Doctors don’t know the exact causes of cholestasis, but many point to liver disorder and a high level of bile acids. Rising pregnancy hormones can also slow the normal flow of bile, causing its salts to enter the bloodstream, which leads to itching. Genes can also play a role.

There is no medication. The only “cure” for the symptoms of cholestasis is a preterm delivery of the baby (or babies) no later than 37 weeks. A prolonged pregnancy can lead to increased risk and complications for the unborn baby, from slight to devastating.

As if I wasn’t itchy enough, I also came down with PUPPPs, another itch-related pregnancy complication. (What is it with me and itches?) PUPPPs has nothing to do with cholestasis but was something I was unlucky to have as well.

So, not only did I itch on the palms of the hands and soles of the feet, but the rest of my body too. Unlike cholestasis, PUPPPs has no ill effect on the baby, but is just as difficult for the mother.

How bad is it? Imagine having a bug bite. You know how those bites sting and itch like crazy? Now imagine thousands of those all over your body. All while at the end of your pregnancy and dealing with a toddler.

Pregnancy with a Toddler

How to cope with cholestasis of pregnancy

For those going through cholestasis or PUPPPs, I feel you.

Trust me when I say I was also online, searching for a treatment for cholestasis. Something to help me get more than an hour of sleep a night and stop feeling depressed. To see the light at the end of the tunnel and stay positive during a difficult pregnancy.

My doctors prescribed medicines like topical ointments and ursodiol. They also monitored me more, checking for my babies’ heartbeats at least three times a week. And they’d test my blood levels regularly as well.

I also found a few ways to make the days not feel so terrible. These didn’t cure me so much as give me an hour or two of relief before it started all over again. At least I had a bit of control, no matter how small, and the feeling that I was doing something to help.

Here are a few coping methods and home remedies for cholestasis of pregnancy and PUPPPs:

How to Stay Positive During Pregnancy

1. Soak in lukewarm or cool water

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A simple way to find temporary relief is to sit in a bath, as often as two or three times a day. Soak in the tub for as long as possible, if only to prevent yourself from scratching. The water will also relax your mind and help you take your mind off of things.

I also suggest adding oatmeal to your baths. Don’t use traditional oatmeal, as these might not drain properly. I really liked the Aveeno packets.

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2. Take cool showers

The worst part of cholestasis was definitely at night. You’re trying to fall (and stay) asleep, but you’ll wake up and find you’d been scratching yourself.

When you’re frustrated at yet another sleepless night, hop in the shower. Let the cool water numb your body and provide a tinge of relief. Do be careful about scrubbing, though—avoid loofahs or anything that will agitate your rashes.

After your shower, sit in front of a fan to cool your body heat down.

3. Apply anti-itch lotion

Most anti-itch lotions and creams work for smaller inflammations like bug bites and poison ivy. Still, feel free to slather on these lotions for a bit of cool relief. Sarna is a popular one among sufferers. Store the lotion in the refrigerator for extra cooling relief.

4. Use tar soap

When I was researching coping methods for cholestasis, I’d often hear about tar soap from fellow itch sufferers. I bought a bar from my local natural grocery store and would use that each time I’d bathe or shower. Here’s a popular tar soap brand.

5. Wear loose clothing

At this late stage in your pregnancy (especially if a twin one), you likely have no choice but to wear loose clothing. Tight clothes make you feel more constricted and itchy and doesn’t allow your skin to breathe.

If need be, buy the biggest maternity tops you can find. Choose loose clothing that doesn’t rub on your rashes to help them itch less.

6. Soak your hands and feet in ice water

Want to numb your hands and feet? One trick is to soak them in ice water. Fill a plastic basin with water and add ice cubes or ice packs like these. You can then soak your hands and feet for a few minutes to relieve severe itching.

You can even place the ice packs near your feet when you sleep at night. Pile towels near your feet so you don’t ruin your mattress, then place ice packs so that your feet touch them.

7. Apply real aloe vera to your body

My mother-in-law has an aloe plant, so I’d refrigerate them, cut them open, and apply them on my body. It felt sticky, but the coolness was a nice relief. I’d also boil the leaves, let them cool down, then lay the leaves on my skin.

8. Drink dandelion root tea

Fellow moms swore by dandelion root tea to prevent the itching from escalating. I was willing to try just about anything, and adding dandelion root to my regular tea consumption was an easy step.

Besides dandelion root tea, fellow moms also drank lemon water and ate a low-fat diet to lessen the itching.


The most challenging part of cholestasis isn’t even the itch, but the feeling of isolation. You feel so alone. Few people have heard of it, much less can relate. It seemed so petty to feel down about a rash of all things. But as anyone who has gone through cholestasis or PUPPPs can agree, it isn’t just a rash.

And so, my biggest advice is to look online for communities going through the same thing. I turned to an online cholestasis group and found many women in the same shoes. Offer your own advice and help. Having others’ support will keep you positive, knowing it will all be okay in the end.

Along with finding a group, turn to your family and friends. Watch funny movies together and order in food so you don’t have to worry about cooking. Draw on your village to help carry you through this madness. And write in a journal, spewing whatever honest thoughts you have.

And for every miserable day and sleepless night, remind yourself that you’re giving your baby one more day to grow. Knowing all this will end with your baby is the most effective coping method of all.

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  1. I also had the awful PUPPS rash with two out of my three pregnancies, and it was overwhelmingly horrible and uncomfortable to say the least. One of the things that helped me, for some reason, was plain yogurt. I would run to the fridge at the middle of the night and actually apply it to my skin and take a couple bites. Also, I may be able to attribute the absence of the rash with my third pregnancy to getting a shower-head water filter. The one we got was from Aqua Sana. I’m not sure if that was what helped, but after we installed it I had no more rash! It’s rough to have this skin rash, esp. during pregnancy. Thanks for your post.

    1. Wow Beth I hadn’t heard of yogurt! I wonder if it’s the healthy bacteria? And that’s amazing you were able to avoid PUPPPs on your third pregnancy. Usually if you had it once, then your subsequent pregnancies are likelier to have it. Thanks so much for commenting and adding your tips! Nina

  2. I am being tested for cholestasis. At the moment I am only 23 weeks. And will have my second lot of test tomorrow. As my first bile acid test came back at 8. The itching on my feet is unbearable at night. My only relief. Is. Ice water Will be glad to have a diagnosis. But am so scared at what’s ahead. This is my first pregnancy. And I struggled. Falling pregnant to start with

    1. Nina Garcia says:

      Hi Ashleigh, so sorry to hear about the possibility of cholestasis. From someone who’s been through it, I know how rough it can get, especially at night! I’d find myself absentmindedly scratching. I agree that ice water is a huge help. Anything cool to keep the itching at bay. Sometimes I’d place ice packs (on towels) at the foot of my bed so that I could put my feet on there. Be prepared for lots of sleepless nights though 🙁 Take lots of naps whenever you can. Also draw baths, which at least gives you a few minutes of non-itching. I’ve also heard that eating a low-fat diet helps. And hopefully once you get the diagnosis, they can give you Ursodial to help a little with the itching. Keep us posted! ~Nina

      1. I had cholestasis with my first, and in now 14 weeks pregnant with my second and terrified! I’m expecting it to happen again but praying it doesn’t. I was induced when my bile acid level hit 66 (it was 40 3 days prior. None of the mess helped). This time around I’m seeing a specialist at 16 weeks! Ice packs on my feet at night worked miracles, and this time I’ll be using essential oils also. Praying everything goes easier now that I’m prepared. Saving this post!

        1. Nina Garcia says:

          Hi Lauren! I hope you don’t get it the second time around, either. Hopefully the specialist will be able to monitor, maybe give you prescriptions to lower the bile acid levels. It’s no fun, especially when the last leg of pregnancy is already so tough as it is. Hoping all goes well the remainder of it! ~Nina

  3. I had Cholestasis with my 2 pregnancies it was horrible. People would see how I would scratch all my body and yet they wouldn’t understand why?! They would tell me to stop scratching to think of something else but when the itch is there you can’t. I felt so lonely with my two pregnancies.

    1. Nina Garcia says:

      I feel you, Jessica. Even though it’s a physical complication, it affects you mentally so much. I was also pretty down when I had it with my twin pregnancy. I can’t imagine having it twice! That was one of the best parts of finally giving birth: no more itching!

  4. Chelsy gray says:

    Hi I’m 21 years old and I’m 34 weeks pregnant with my first baby. At 31 weeks I was diagnosed with cholistasis and given ursidol to treat it but my bile acids only got worse here currently at 127 when I was told it should be a 10. I’m in and out of hospitals 3 times a week due to minor preeclampsia also and because I have cardiovascular problems so I’m considered high risk but this itchin is horrible I’ve tried everything the cold showers, I even froze aloe Vera gel and rubbed that on me, I even rubbed a package of frozen meat on me, oatmeal bath, Benadryl cream, ice packs, and I even taken Children’s Benadryl just to help me sleep but I can’t get anything to work I have bruises and scratches and scabs all over my body from scratching so much…doctors are planning to induce me before or at 37 weeks but with my heart condition im being transferred to Texas children’s to deliver and to proceed with my care because they don’t think my heart will be able to make it going through natural labor and they don’t want to do c section if I can go somewhere for better care….I’m worried with my bile acids not getting better if the risk of higher?

    1. Nina Garcia says:

      Oh Chelsy, I’m so sorry you’re going through this! Cholestasis is rough, period. The nights are the worst. I remember only sleeping at most 1-2 hours because of the constant itching, much of it subconscious, too. It was easily one of the hardest times of my life, both physically and mentally. Hang in there, mama! You’ve got just a few more weeks to go. It looks like your doctors are monitoring you well, so keep checking in with them. You will get through this!

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