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<section article="gho" article_name="Health Occupations" number="8-6C-03" title_number="8" title_name="Nurses" subtitle_number="6C" subtitle_name="Licensed Direct-Entry Midwives">
  <text>A licensed direct–entry midwife may not assume or continue to take responsibility for a patient’s pregnancy and birth care and shall arrange for the orderly transfer of care to a health care practitioner for a patient who is already under the care of the licensed direct–entry midwife, if any of the following disorders or situations is found to be present at the initial interview or if any of the following disorders or situations occur as prenatal care proceeds:</text>
  <level label="1">
    <text>Diabetes mellitus, including uncontrolled gestational diabetes;</text>
  </level>
  <level label="2">
    <text>Hyperthyroidism treated with medication;</text>
  </level>
  <level label="3">
    <text>Uncontrolled hypothyroidism;</text>
  </level>
  <level label="4">
    <text>Epilepsy with seizures or antiepileptic drug use during the previous 12 months;</text>
  </level>
  <level label="5">
    <text>Coagulation disorders;</text>
  </level>
  <level label="6">
    <text>Chronic pulmonary disease;</text>
  </level>
  <level label="7">
    <text>Heart disease in which there are arrhythmias or murmurs except when, after evaluation, it is the opinion of a physician licensed under Title 14 of this article or a licensed nurse certified as a nurse–midwife or a nurse practitioner under this title that midwifery care may proceed;</text>
  </level>
  <level label="8">
    <text>Hypertension, including pregnancy–induced hypertension (PIH);</text>
  </level>
  <level label="9">
    <text>Renal disease;</text>
  </level>
  <level label="10">
    <text>Previous uterine surgery, including a cesarean section or myomectomy;</text>
  </level>
  <level label="11">
    <text>Indications that the fetus has died in utero;</text>
  </level>
  <level label="12">
    <text>Premature labor (gestation less than 37 weeks);</text>
  </level>
  <level label="13">
    <text>Multiple gestation;</text>
  </level>
  <level label="14">
    <text>Noncephalic presentation at or after 38 weeks;</text>
  </level>
  <level label="15">
    <text>Placenta previa or abruption;</text>
  </level>
  <level label="16">
    <text>Preeclampsia;</text>
  </level>
  <level label="17">
    <text>Severe anemia, defined as hemoglobin less than 10 g/dL:</text>
    <level label="i">
      <text>That has been measured after treatment; or</text>
    </level>
    <level label="ii">
      <text>Based on blood tests performed at or after 36 weeks;</text>
    </level>
  </level>
  <level label="18">
    <text>Uncommon diseases and disorders, including Addison’s disease, Cushing’s disease, systemic lupus erythematosus, antiphospholipid syndrome, scleroderma, rheumatoid arthritis, periarteritis nodosa, and Marfan’s syndrome;</text>
  </level>
  <level label="19">
    <text>AIDS/HIV;</text>
  </level>
  <level label="20">
    <text>Hepatitis;</text>
  </level>
  <level label="21">
    <text>Acute toxoplasmosis infection, if the patient is symptomatic;</text>
  </level>
  <level label="22">
    <text>Acute Rubella infection during pregnancy;</text>
  </level>
  <level label="23">
    <text>Acute cytomegalovirus infection, if the patient is symptomatic;</text>
  </level>
  <level label="24">
    <text>Acute Parvovirus infection, if the patient is symptomatic;</text>
  </level>
  <level label="25">
    <text>Alcohol abuse, substance abuse, or prescription abuse during pregnancy;</text>
  </level>
  <level label="26">
    <text>Continued daily tobacco use into the second trimester;</text>
  </level>
  <level label="27">
    <text>Thrombosis;</text>
  </level>
  <level label="28">
    <text>Inflammatory bowel disease that is not in remission;</text>
  </level>
  <level label="29">
    <text>Primary genital herpes simplex virus infection during the third trimester or active genital herpes lesions at the time of labor;</text>
  </level>
  <level label="30">
    <text>Significant fetal congenital anomaly that directly impacts the birthing process or requires immediate emergency care, as determined by the Board in regulations;</text>
  </level>
  <level label="31">
    <text>Ectopic pregnancy; or</text>
  </level>
  <level label="32">
    <text>Post term maturity (gestational age 42 0/7 weeks and beyond).</text>
  </level>
</section>
