Upon completion of this course, the learner will be able to:

• Identify those at risk of Intrahepatic Cholestasis of Pregnancy (ICP), and offer prevention techniques
• Identify the signs & symptoms of ICP
• Explain diagnostic testing recommendations and normal ranges
• Explain the clinical relevance of different levels of elevated bile acids
• Explain potential holistic and alternative treatments
• Develop and/or explain an ongoing and individualized treatment plan (depending on scope of care)
• Identify when to transfer care out of midwifery




Intrahepatic Cholestasis of Pregnancy (ICP) is a complex liver disease which typically presents in the third trimester of pregnancy. 

This course reviews the evidence for the best approach to risk-based management, and provides a plan for holistic preventative support of at-risk clients as well as the holistic treatment of clients with mild ICP in an out-of-hospital setting.



HiveCE is an approved provider of continuing education by the California Board of Nursing, and this course is provider approved by the California Board of Registered Nursing, Provider Number 17686, for 3 contact hours, through November 30th, 2025. (This is widely accepted nationwide as continuing education for nurses and midwives. This course is accepted by NARM as Category 1 CE for CPM renewal.)

Accepted by NARM for the Midwifery Bridge Certificate, Category 1.

This course was previously approved by MEAC for 3 hours of continuing education. Approval number M2122-44-1201DE  through December 31, 2023, and approval number M1920-33-1109DE through November 30, 2021.


Note: Course completion does not authorize the learner to use skills outside their scope. Please refer to your state guidelines for determining scope of care.

For information regarding our refund policy and other Frequently Asked Questions, please refer to our FAQ. If you have additional questions, please email jesica@HiveCE.com.



This course is a fundraiser for the Midwives Association of Washington State (MAWS). 

Course Evaluations

Shared with permission from our

“Great course. Highly informative. I will definitely be implementing this information into my practice.”

Carissa C

Licensed Midwife

“Excellent course! Will recommend to colleagues for sure!”

Michelle L

Certified Nurse Midwife

“Thank you for the holistic protocol! I will definitely use this in my practice.”

Mischa O

Licensed Midwife

“Thank you to this presenter. She presented in a way that helped me to retain the information. The discussion as well as slides was very helpful. The information was clear, concise and repeated again and again so it would sink in. I am so grateful to better understand this condition, the herbal protocol for support/prevention and the labs to use to evaluate.”

Anne H

Licensed Midwife

“So excited to implement these protocols!! Thank you for such an amazing protocol...literally have a past client at 12w TWINS and Hx of Choleostasis with hospital induction last pregnancy... calling her right now!! Thank you thank you thank you!”

Randi P

Licensed Midwife

“Awesome informative course”

Rachel L

Registered Midwife (Canada)

“EXCELLENT!!!! I wish that I had taken this course a while ago. We had three clients with ICP over the last two years that had to be transferred out whose levels would have been appropriate to stay in care per this lecture. Wonderful presentation.”

Amy W

Licensed Midwife

“Great course and wonderful refresher with deeper learning gained into more specific guidelines for management.”

Darcie M

Registered Nurse and Midwife

“I love having this holistic protocol in my arsenal! We have managed a few ICP cases over the years and they seem always to end up in the hospital. Love these lab value cutoffs for safety and an approach that focuses on prevention!”

Meg G

Certified Professional Midwife

Course curriculum

  • 01
    1: Understanding and Diagnosing ICP
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    • How To Use HiveCE
    • 1.1 What is ICP?
    • 1.2 Maternal and Fetal Etiology
    • 1.3 Recent Meta-Analysis of Stillbirths Rate by Bile Acid Level
    • 1.4 Risk Factors and S/S
    • 1.5 Diagnostic Tests
  • 02
    2: Prevention and Treatment
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  • 03
    3: Take Aways
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  • 04
    Evaluation & Post-test
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Reviews