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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Reviews

  • By Kristin Brennan

    “Excellent. I used the protocol that was suggested for a client that had cholestasis in her prior pregnancy. And it worked! I felt so confident and informed after this class.”

    “Excellent. I used the protocol that was suggested for a client that had cholestasis in her prior pregnancy. And it worked! I felt so confident and informed after this class.”

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  • By Korina Pubanz

    “The practice protocol and useful information in this online course will valuable reference material. I will look forward to the presenter's' ongoing research on the topic. Thank you”

    “The practice protocol and useful information in this online course will valuable reference material. I will look forward to the presenter's' ongoing research on the topic. Thank you”

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  • By Rachel Pugh

    “This was a fantastic training! I have used the information with a current client who had ICP with her first pregnancy and this pregnancy has been complication free and my client feels amazing! She is so surprised how different she feels when she c...”

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    “This was a fantastic training! I have used the information with a current client who had ICP with her first pregnancy and this pregnancy has been complication free and my client feels amazing! She is so surprised how different she feels when she compares her pregnancies. I contribute it all to the information in this training and a wonderful client who followed it to a T. Thank you for offering this training! ”

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  • By rivka max

    “I found this topic very interesting. I had always understood that the only thing to be done about ICP was to have an early induction to prevent what was a very high rate of still birth. This course opened a whole new set of possibilities! It w...”

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    “I found this topic very interesting. I had always understood that the only thing to be done about ICP was to have an early induction to prevent what was a very high rate of still birth. This course opened a whole new set of possibilities! It was well presented, and her protocol sounds amazing! Thank you Ashley for the research and the time you put into this!”

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