# COMAR Title 10 — Maryland Department of Health

## Subtitle 64 — Board of Nursing — Licensed Direct-Entry Midwives

### Chapter 01 — Practice of Licensed Direct-Entry Midwives

#### Regulation .09 Patient’s Refusal to Transfer Care.

*COMAR 10.64.01.09*

A. If a patient chooses to give birth at home in a situation prohibited by this chapter or in which a licensed direct-entry midwife recommends transfer, the licensed direct-entry midwife shall:

  (1) Transfer care of the patient to a health care practitioner; and

  (2) Complete the standard form developed under Regulation .10 of this chapter and:

    (a) Submit the completed form to the accepting health care practitioner; and

    (b) Cease to take responsibility for the patient’s pregnancy care within 1 week after the transfer.

B. If birth is imminent and the patient refuses to be transferred after the licensed direct-entry midwife determines that a transfer is necessary, the licensed direct-entry midwife shall:

  (1) Call 9-1-1 and remain with the patient until emergency services personnel arrive; and

  (2) Transfer care and give a verbal report of the care provided to the emergency medical services providers.