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.


Approved by MEAC for 3 hours of continuing education (approval number M1920-33-1109DE through November 14, 2021). 

Approved for the NARM Midwifery Bridge Certificate, Category 1.


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

Course curriculum

  • 01
    1: Understanding and Diagnosing ICP
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    • 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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    • 2.1 Medical Management
    • 2.2 Holistic Support and Treatment Options
    • 2.3 A New Protocol: Holistic Prevention for ICP Recurrence
    • 2.4 Expectant Management in the Community Birth Setting
    • 2.5 Case Study
    • 2.6 Continued Research
  • 03
    3: Take Aways
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    • 3.1 Points to Remember
    • Printable PDF: Holistic Management Protocol for ICP
    • 3.2 Q&A with Live Audience
    • Article: Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses
    • Article: RCOG Guideline No. 43 Obstretric Cholestasis
    • Article: Predictors of adverse neonatal outcomes in intrahepatic cholestasis of pregnancy
    • Reading: Association of Severe Intrahepatic Cholestasis of Pregnancy With Adverse Pregnancy Outcomes: A Prospective Population-Based Case-Control Study
    • MEAC Evaluation Questions
    • Post-Test and MEAC CE Certificate

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