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 for implementing and overseeing the operational policies of the birth center. (2) The administrative 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. (4) One person may serve as the administrative director and the clinic administrator 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, certified professional midwife, family practitioner or gynecologist. The Director of Medical Affairs must be licensed to practice in the Commonwealth, and their professional scope of practice must include preconception, prenatal, labor, birth and postpartum care and earlycare of the newborn and who maybe the primaryattendants during the perinatal period; and (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, certified professional midwife, or an obstetrician or family practitioner. The Birth Attendant must be licensed to practice in the Commonwealth, and their professional scope of practice must include preconception, prenatal, labor, birth and postpartum care and early care of the newborn. The Birth Attendant 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 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.