105 CMR 130.811
Staffing
A birth center shall have adequate, trained staff who are licensed as required and are
available at all times to meet the needs of its patients, including but not limited to:
(A) Administrative Director of the Birth Center.
(1) A birth center shall have an administrative director who shall be responsible to the
hospital administrator for implementing and overseeing the operational policies of the birth
center.
(2) The director must have health care and business experience.
(3) One person may serve as both administrative director and director of Medical Affairs
if the individual meets the requirements for both positions and can perform the duties of both
positions.
(B) Director of Medical Affairs.
(1) A birth center shall have a Director of Medical Affairs who shall be an obstetrician, a
certified nurse midwife, family practitioner or gynecologist.
(2) The Director of Medical Affairs shall be responsible for advising and consulting with
the medical staff of the birth center on all matters related to medical management of
pregnancy, birth, post-partum, newborn and gynecologic health care including policies,
procedures and protocols that are outside the scope of midwifery practice.
(C) Required Staffing at Births.
(1) Birth Attendant. A certified nurse-midwife or an obstetrician or family practitioner shall
attend each pregnant person in labor from the time of admission; during labor; during the
birth; and through the immediate postpartum period. Such attendance may be delegated only
to another birth attendant.
(2) Birth Assistant. A second staff person shall also be present at each birth. The second
staff person must be either a certified nurse-midwife or a licensed nurse, or a provider
licensed or certified by the Department as specified in Department guidelines. For purposes
of 105 CMR 140.902(C), licensed nurses shall include registered nurses and licensed
practical nurses.
(3) Licensed nurses functioning as a birth assistant must have experience providing direct
clinical care to laboring and birthing patients, in any setting, that includes training or
experience in:
(a) adult and infant resuscitation;
(b) assessing the phases and stages of labor;
(c) psychology and physiology of labor and delivery; and
(d) equipment and supplies used for labor and delivery.