<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 10.27.05.06" title_num="10" subtitle_num="27" chapter_num="05" heading="Scope of Practice.">
  <paragraph num="A.">
    <text>A certified nurse midwife who meets the requirements of Regulation .02 of this chapter may perform the following functions:</text>
    <paragraph num="(1)">
      <text>Independent management of clients appropriate to the skill and educational preparation of the certified nurse midwife and the nurse midwife's clinical practice guidelines;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Consult or collaborate with a physician or other health care provider as needed; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Refer clients with complications beyond the scope of practice of the certified nurse midwife to a licensed physician.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>A certified nurse midwife shall keep a record of all cases attended and maintain medical records in accordance with Health-General Article, Title 4, Subtitle 4, Annotated Code of Maryland.</text>
  </paragraph>
  <paragraph num="C.">
    <text>A certified nurse midwife has the right and obligation to refuse to perform any delegated medical act, oral or written, if, in the certified nurse midwife’s judgment, it is unsafe or an invalidly prescribed medical act or beyond the competence of the certified nurse midwife, in which case the nurse midwife shall notify the delegating physician at once.</text>
  </paragraph>
  <paragraph num="D.">
    <text>A certified nurse midwife shall comply with applicable State and federal law.</text>
  </paragraph>
</regulation>