LAC 48:I.6751
LAC 48:I.6751. Required Physician Consultation, Postpartum Period
Cite as La. Admin. Code tit. 48, pt. I, § 6751
A. The licensed healthcare practitioner shall obtain medical consultation or refer for emergent medical care any woman who, during the postpartum period:
1. has a third-degree or fourth-degree perineal laceration;
2. has uterine atony;
3. bleeds in an amount greater than 500 milliliters and still continuing to bleed;
4. does not urinate or empty her genitourinary bladder within two hours of birth;
5. develops a fever greater than 100.4 degrees Fahrenheit or 38 degrees Centigrade on any two of the first 10 days postpartum, excluding the first 24 hours;
6. develops foul smelling lochia; or
7. develops blood pressure below 100/50 if pulse exceeds 100, pallor, cold clammy skin, and/or weak pulse.
B. The licensed healthcare practitioner shall obtain medical consultation or refer for emergent medical care any infant who:
1. has an Apgar score of seven or less at five minutes;
2. has any obvious anomaly;
3. develops grunting respirations, retractions, or cyanosis;
4. has cardiac irregularities;
5. has a pale, cyanotic, or grey color;
6. develops jaundice within 48 hours of birth;
7. has an abnormal cry;
8. weighs less than 5 pounds or weighs more than 10 pounds;
9. shows signs of prematurity, dysmaturity, or post maturity;
10. has meconium staining of the placenta, cord, and/or infant with signs or symptoms of aspiration pneumonia;
11. does not urinate or pass meconium in the first 24 hours after birth;
12. is lethargic or does not feed well;
13. has edema;
14. appears weak or flaccid, has abnormal feces, or appears not to be normal in any other respect;
15. has persistent temperature below 97 degrees Fahrenheit per FSBC policy;
16. has jitteriness not resolved after feeding; or
17. has a blood glucose level of less than 45mg/dL.
C. The FSBC shall develop, implement, and enforce written policies to provide follow-up postpartum care to the newborn and the mother either directly or by referral. Follow up care may be provided in the FSBC, at the mother’s residence, by telephone, or by a combination of these methods in accordance with accepted standards of practice.