12 AAC 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 100.4УИ F. or 38УИ C.;

(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 other than very light;

(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 a home delivery if, following the consultation with a physician or referral for medical care, the client does not have any of the conditions set out in AS 08.65.140 (d).

(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 antibiotic intravenous therapy treatment on a woman who tests positive for Group B Streptococci and chooses antibiotic treatment.

History: Eff. 5/11/94, Register 130; am 5/2/2004, Register 170

Authority: AS 08.65.030

AS 08.65.140

AS 08.65.190

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