Ch. 26, § 11. Provision of Services

(a) A center may not accept a pregnant woman under sixteen (16) years of age for care. (b) A center may not perform a delivery if the pregnant woman exhibits medical evidence of the following conditions: (i) Hypertension, pre-eclampsia, or eclampsia; (ii) Multiple gestation (i.e. twins); (iii) Placental abnormalities, including previa or abruptio, which may threaten the neonate; (iv) Premature labor, post-maturity labor, or medically-induced labor; (v) More than one (1) prior cesarean section with no history of a vaginal delivery; a cesarean section within eighteen (18) months of the current delivery; or, any cesarean section that was surgically closed with a classical or vertical uterine incision; or (vi) Known breech or other abnormal, non-vertex, presentation. (c) If a center accepts a pregnant woman, the center shall provide services according to the following standards: (i) A physician, CNM, or CPM shall attend each delivery at the center. A second staff member shall also attend the delivery. (ii) If more than one patient is in labor at a center, a minimum of one staff member per a patient must be present at the center. (iii) After a delivery, a CNM, CPM, or RN shall be present in the center at all times until the mother and newborn are stable and discharged from care. (d) A center shall develop, implement, and enforce written operational policies for: (i) Informed consent that is obtained prior to the onset of labor and shall include evidence of an explanation by personnel of the services offered and potential risks; (ii) Orientation and education of patients, family, and support persons regarding childbirth and newborn care; (iii) Consultation, back-up services, transfer, and transport of the patient(s) to the hospital where appropriate care is available; (iv) Emergency transport of the patient(s) if indicated, including method of providing pertinent medical information to the receiving hospital; (v) Discharge of the mothers and newborns within 24 hours after delivery; (vi) A program for prompt follow-up care and postpartum evaluation after discharge; and (vii) Registration of birth and reporting of complications, anomalies, and stillbirths.