The practice of direct-entry midwifery does not include: Pharmacological induction or augmentation of labor or artificial rupture of membranes before the onset of labor; Surgical delivery or any surgery except an emergency episiotomy; Use of forceps or vacuum extractor; Except for the administration of a local anesthetic, administration of an anesthetic; Administration of any kind of narcotic analgesic; or Administration of any prescription medication not authorized in accordance with Regulation .07 of this chapter. A licensed direct-entry midwife may not assume care or continue to take responsibility for a patient’s pregnancy and birth care if a finding of any of the disorders or situations listed under §C of this regulation is found to be present: At the initial interview; During an examination of the patient; While obtaining a patient history or at subsequent prenatal visits; As a result of a laboratory or other test; or After consultation with another health care practitioner. If any of the following disorders or situations exist, the licensed direct-entry midwife shall arrange for the orderly transfer of care to a health care practitioner: Diabetes mellitus, including uncontrolled gestational diabetes; Hyperthyroidism treated with medication; Uncontrolled hypothyroidism; Epilepsy with seizures or antiepileptic drug use during the previous 12 months; Coagulation disorders; Chronic pulmonary disease; Heart disease in which there are arrhythmias or murmurs except when, after evaluation, it is the opinion of a physician licensed under Health Occupations Article, Title 14, Annotated Code of Maryland, or a licensed nurse certified as a nurse-midwife or a nurse practitioner under Health Occupations Article, Title 8, Annotated Code of Maryland, that midwifery care may proceed; Hypertension, including pregnancy-induced hypertension (PIH); Renal disease; Except as otherwise provided in Health Occupations Article, §8-6C-04(a)(11), Annotated Code of Maryland, Rh sensitization with positive antibody titer; Previous uterine surgery, including a cesarean section or myomectomy; Indications that the fetus has died in utero; Premature labor (gestation less than 37 weeks); Multiple gestation; Noncephalic presentation at or after 38 weeks; Placenta previa or abruption; Preeclampsia; Severe anemia, defined as hemoglobin less than 10 g/dL; Uncommon diseases and disorders, including: Addison’s disease; Cushing’s disease; Systemic lupus erythematosus; Antiphospholipid syndrome; Scleroderma; Rheumatoid arthritis; Periarteritis nodosa; Marfan’s syndrome; and Other systemic and rare diseases and disorders, as determined by the Department; AIDS/HIV; Hepatitis A through G and non-A through G; Acute toxoplasmosis infection, if the patient is symptomatic; Acute Rubella infection during pregnancy; Acute cytomegalovirus infection, if the patient is symptomatic; Acute Parvovirus infection, if the patient is symptomatic; Alcohol abuse, substance abuse, or prescription abuse during pregnancy; Continued daily tobacco use into the second trimester; Thrombosis; Inflammatory bowel disease that is not in remission; Primary herpes simplex virus, genital infection during pregnancy, or any active genital lesions at the time of delivery; Significant fetal congenital anomaly; Ectopic pregnancy; Prepregnancy body mass index (BMI) of less than 18.5 or 35 or more; or Post term maturity (gestational age 42 0/7 weeks and beyond).