Section 12.14.510. Intrapartum care.

	(a)  Intrapartum care includes the management of low risk women whose labor, delivery, postpartum course, and infant are not reasonably expected to require consultation with a physician or referral for medical care.  
	(b)  A certified direct-entry midwife may not perform a vaginal examination on a client with ruptured membranes and no onset of labor unless  
		(1) less than 24 hours have elapsed since the rupture of the membranes; and  
		(2) there is a reasonable and strong suspicion of a prolapsed cord.  
	(c)  A certified direct-entry midwife shall obtain medical consultation or refer for medical care any client who during the intrapartum period  
		(1) develops a blood pressure of 160/100 or an increase of 30 mm Hg systolic or 15 mm Hg diastolic over the baseline blood pressure;  
		(2) develops a fever of 100.5 degrees Fahrenheit or 38 degrees Celsius;  
		(3) has bleeding other than show before delivery;  
		(4) develops severe headaches, epigastric pain, or visual disturbance;  
		(5) develops respiratory distress;  
		(6) has persistent or recurrent fetal heart tones below 100 or above 170 beats per minute at any time, or a fetal heart rate that is irregular or showing late or variable decelerations;  
		(7) has meconium stained amniotic fluid that is thick or has particulate matter;  
		(8) desires medical consultation or transfer; or  
		(9) develops symptoms or signs of an allergic reaction.  
	(d)  A consultation or referral as required in (c) of this section does not preclude the possibility of an out-of-hospital delivery if, following the consultation with the consulting provider or referral for medical care, the client does not have any of the conditions set out in 12 AAC 14.150.  
	(e)  A certified direct-entry midwife shall ensure that a client on whom cardiopulmonary resuscitation is administered or treatment for anaphylactic shock is administered is immediately transported to a hospital.  
	(f)  A certified direct-entry midwife shall accompany to the hospital any client requiring hospitalization and provide copies of all pertinent client data and make a verbal report to the physician assuming care. If reasonably possible, the certified direct-entry midwife shall remain with the client to receive information regarding the results of the client's hospitalization.  
	(g)  A certified direct-entry midwife may start prophylactic antibiotic intravenous therapy for Group B Streptococci in accordance with Prevention of Perinatal Group B Streptococcal Disease: Revised Guidelines from CDC, adopted by reference in 12 AAC 14.570(9).  

Authorities

08.65.030;08.65.140;08.65.190

Notes

Authority

AS 08.65.030 AS 08.65.140 AS 08.65.190

History

Eff. 5/11/94, Register 130; am 5/2/2004, Register 170; am 10/18/2007, Register 184; am 3/2/2011, Register 197; am 9/9/2016, Register 219