When Bryn got pregnant with her third child, she planned for another unmedicated birth in a birth center. The plan changed when she was diagnosed with Intrahepatic Cholestasis of Pregnancy (ICP) at 33 weeks and risked out of the birth center. The following weeks were filled with confusion and frustration as she switched to an OB practice and tried to gather as much information on ICP as she could. She was induced at 37 weeks, and her body ended up producing contractions on its own after minimal interventions. Although it was not what she pictured, Bryn was able to have a redemptive unmedicated birth. 

Bryn was induced at 37 weeks for ICP. When she was admitted that morning at 6am, her cervix was closed, high and thick. At 9:30am, she was given one dose of cytotec, which gave her contractions that were a minute apart, though not painful. That dilated her to a 2, so they inserted a foley balloon at 1:30pm. Bryn got very lucky, and the resident allowed her to have 45 minutes off the monitor, 15 minutes on instead of continuous fetal monitoring. She was the first person her nurse had ever seen walk the halls with a foley in!

Only 2 hours later, the foley balloon fell out and she was dilated to a 6. The foley balloon allowed Bryn’s body to start contracting on its own, so it was decided she would not need Pitocin. With Bryn’s first two labors, her body stopped dilating (at 8 and 7 cm) and did not enter transition until her water was manually broken. This labor was no different, and when they checked her 4 hours later, she was still at a 6. Afraid of being in more pain and of a prolapsed cord, she did not consent to getting her water broken at that time, but continued to walk around and cope in the shower.

Bryn came close to getting an epidural at this point, but thanks to her doula and a nurse who had had unmedicated births herself, she was able to continue with her desired plan. At 9:30pm, they checked her again and she was still at a 6. Bryn chose to get a dose of fentanyl and have her water manually broken. Two contractions later, she was in transition. She had the urge to push at 10:20pm, and Israel was born just 4 minutes later! 

Bryn Koger Bio

Bryn lives in Atlanta, GA with her husband and 3 kids, Elias (5), Eden (3), and Israel (7 weeks). She is a stay-at-home mom, but also is trained as a doula and occasionally attends births. 


ICP Care


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