Regulation .05 Required Transfer of Care.
Regulation .05 Required Transfer of Care.LinkCopy Citation
A.
Except for §B of this regulation, a licensed direct-entry midwife shall arrange immediate emergency transfer to a hospital if:
(1)
The patient requests transfer; or
(2)
The patient or newborn is determined to have any of the following conditions during labor, delivery, or the immediate postpartum period:
(a)
Unforeseen noncephalic presentation;
(b)
Unforeseen multiple gestation;
(c)
Nonreassuring fetal heart rate or pattern, including:
(i)
Tachycardia
(ii)
Bradycardia;
(iii)
Significant change in baseline; or
(iv)
Persistent late or severe variable decelerations;
(d)
Prolapsed cord;
(e)
Unresolved maternal hemorrhage;
(f)
Retained placenta;
(g)
Signs of fetal or maternal infection;
(h)
Patient with a third or fourth degree laceration or a laceration beyond the licensed direct-entry midwife’s ability to repair;
(i)
Apgar of less than seven at 5 minutes;
(j)
Obvious congenital anomalies;
(k)
Need for chest compressions during neonatal resuscitation;
(l)
Newborn with persistent central cyanosis;
(m)
Newborn with persistent grunting and retractions;
(n)
Newborn with abnormal vital signs;
(o)
Gross or thick meconium staining, when discovered; or
(p)
Newborn with excessive dehydration due to inability to feed.
B.
If transfer is not possible because of imminent delivery, the licensed direct-entry midwife shall consult with a health care provider for guidance on further management of the patient and to determine when transfer may be safely arranged, if required.
C.
A licensed direct-entry midwife shall immediately transfer the care of a patient to a health care provider for the treatment of any significant postpartum morbidity, including:
(1)
Uncontrolled postpartum hemorrhage;
(2)
Preeclampsia;
(3)
Thrombo-embolism;
(4)
An infection; or
(5)
A postpartum mental health disorder.
D.
A licensed direct-entry midwife who is required to transfer care of a patient under this regulation may continue other aspects of postpartum care in consultation with the treating health care practitioner.