ARM 24.111.603. DIRECT-ENTRY MIDWIFE PROTOCOL STANDARD LIST REQUIRED FOR APPLICATION

(1) The antepartum protocol standards include, but are not limited to, the following: (a) abruptio placenta (suspected); (b) anemia; (c) bleeding, first, second and third trimesters; (d) breech presentation; (e) candidiasis; (f) care schedule; (g) date/size discrepancy; (h) ectopic pregnancy; (i) fetal demise first, second, third trimester; (j) genetic counsel; (k) glycosuria/glucose screen; (l) group beta strep; (m) Hepatitis B; (n) HIV; (o) human papilloma virus (HPV); (p) hyperemesis gravidarum; (q) internal pelvic examination; (r) intrauterine growth retardation; (s) minor pregnancy discomfort (heartburn, constipation, insomnia, etc.); (t) placenta previa (suspected); (u) polyhydramnios; (v) post dates pregnancy; (w) pregnancy induced hypertension (mild, severe); (x) proteinuria; (y) Rh negative; (z) sexually transmitted diseases (chlamydia, herpes, bacterial vaginosis, gonorrhea, trichomosis, etc.); (aa) transfer of care/termination of midwife-parent relationship; (bb) twins (diagnosis of); (cc) ultrasound (indications for); (dd) urinary tract infection; (ee) vaginal birth after cesarean. (2) The intrapartum protocol standards include, but are not limited to, the following: (a) amnionitis/chorioamnionitis; (b) bleeding in labor; (c) care schedule; (d) edematous cervical lip; (e) emergency breech delivery; (f) emergency twin delivery; (g) face presentation; (h) fetal distress; (i) fetal heart rate evaluation; (j) indications for transfer of care; (k) meconium staining; (l) nuchal cord; (m) oxygen in labor; (n) perineal support; (o) placenta abruptio; (p) posterior fetal presentation; (q) premature labor; (r) prolonged rupture of membranes; (s) prolapsed cord; (t) shoulder dystocia; (u) stillbirth; (v) vaginal birth after cesarean. (3) The postpartum protocol standards include, but are not limited to, the following: (a) assessment of placenta; (b) breast care; (c) care schedule; (d) delivery of placenta; (e) depression; (f) hematoma; (g) hemorrhage; (h) hemorrhoids; (i) perineal second degree laceration or episiotomy repair (suture); (j) preparation of mother for transport; (k) retained placenta (manual removal); (l) Rh negative mom; (m) shock; (n) subinvolution; (o) uterine infection; (p) uterine inversion. (4) The newborn protocol standards include, but are not limited to, the following: (a) care schedule (postpartum visits); (b) eye prophylaxis; (c) hypoglycemia (suspected); (d) hypothermia; (e) infection (suspected sepsis); (f) evaluation of jaundice; (g) neonatal resuscitation; (h) newborn examination to include gestational age determination and assessment of minor anomalies; (i) newborn metabolic screening; (j) normal newborn transition to include maintenance of body temperature, cardiopulmonary function; (k) normal infant feeding patterns; (l) polycythemia (suspected); (m) preparation of infant for transport; (n) problems of large- and small-for-gestational-age infants; (o) respiratory distress; (p) umbilical cord care; (q) vitamin K administration.