Obstetric cholestasis (OC) is the most common liver condition specific to pregnancy and affects around 5,000 women in the UK every year. It's generally benign for the mother although the main presenting symptom of pruritus can sometimes be so severe that the woman scratches herself until she bleeds. However, the main concerns are for the fetus, as the condition is associated with an increased risk of fetal distress, spontaneous premature labour and stillbirth. This article aims to provide information about the condition so that as a practising midwife you can offer women sufficient support should OC be suspected or diagnosed.