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Alaska Administrative Code (Last Updated: January 12, 2017) |
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Title 7. Health and Social Services. |
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Part 7.1. Administration. |
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Chapter 7.12. Facilities and Local Units. |
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Article 7.12.4. Specialized Hospitals. |
Section 7.12.446. Determination of low-risk maternal client.
Latest version.
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For purposes of 7 AAC 12.401 - 7 AAC 12.449, the department will consider a woman who seeks the services of a free-standing birth center to be a low-risk maternal client if, based on physical examinations and risk assessments conducted in accordance with the standards developed under 7 AAC 12.403(f), the woman (1) is in general good health with uncomplicated prenatal care; (2) is 16 years of age or older; (3) has documented evidence of ongoing prenatal care or meets the requirements of 7 AAC 12.403(h)(1) - (3); (4) has no major medical problems; (5) has no previous significant obstetrical complications that are likely to recur; (6) has gestation that is (A) greater than or equal to 37 weeks at the onset of labor; and (B) less than or equal to 42 weeks; (7) has never had uterine wall surgery, including a previous cesarean section; (8) is appropriate for a setting where anesthesia is limited to local anesthesia as described in 7 AAC 12.403(n); (9) during labor, is progressing normally; and (10) has no signs or symptoms that cannot be remedied by normal midwifery intervention before labor, and has no signs or symptoms during labor, of (A) active herpes genitalis; (B) chronic or significant hypertension; in this subparagraph, "significant hypertension" means a sustained blood pressure in excess of 140/90, or the presence of chronic hypertension that has been diagnosed before pregnancy; (C) placenta previa or abruption; (D) chorioamnionitis; (E) anemia or thrombocytopenia; (F) nonreassuring fetal heart tones; in this subparagraph, "nonreassuring fetal heart tones" means that, based on assessment of fetal heart tones, the physician or midwife has lost confidence regarding, or is unable to alleviate doubts about, fetal condition; (G) thick fetal meconium; (H) breech presentation; (I) prolonged ruptured membranes in the absence of active labor; in this subparagraph, "prolonged" means that the membranes have been ruptured or leaking for 24 hours or longer; (J) toxemia; (K) poly-hydramnios or oligo-hydramnios; (L) intrauterine growth retardation; (M) multiple gestation; (N) intrauterine fetal malformation; (O) insulin-dependent diabetes mellitus or uncontrolled gestational diabetes; (P) immunosuppressive disorder; (Q) alcoholism or inappropriate use of controlled substances, including those obtained by prescription; (R) compromised fetal status according to antepartum testing; or (S) abnormal labor pattern as defined in the birth center's risk assessment tool developed under 7 AAC 12.403(f) and its policy and procedure manual.
Authorities
47.32.010;47.32.030