ARM 24.111.610. HIGH RISK PREGNANCY: CONDITIONS REQUIRING PRIMARY CARE BY A PHYSICIAN

(1) If the following conditions are present, the licensed direct-entry midwife shall not accept the woman as a client: (a) chronic medical problems: (i) cardiac disease (Class II or greater); (ii) diabetes mellitus requiring medication; (iii) essential hypertension (greater than 140/90 Hg, not controlled by medication); (iv) hemoglobinopathies: (v) renal disease (chronic, diagnosed, not urinary tract infection); (vi) thrombophlebitis or pulmonary embolism; (vii) epilepsy currently on medication; (viii) current severe psychiatric condition requiring medication within a six-month period prior to pregnancy; (ix) active: tuberculosis, syphilis, gonorrhea, hepatitis, AIDS, genital herpes at onset of labor; (x) current drug or alcohol abuse/dependency; (xi) current malignant disease; (xii) chronic obstructive pulmonary disease, except for controlled asthma. (b) current pregnancy related conditions: (i) pregnancy induced hypertension (preeclamptic or eclamptic symptoms); (ii) premature labor (before 36 1/2 weeks gestation verified estimated date of delivery by dates and physical exam); (iii) placental abruption; (iv) placenta previa at onset of labor; (v) has a fetus in any presentation other than vertex at onset of labor; (vi) multiple gestation; (vii) contracts primary genital herpes in the first trimester; (viii) Rh sensitization. (c) previous obstetrical history: (i) previous Rh sensitization; (ii) history of inverted uterus.