<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".09" citation="COMAR 10.64.01.09" title_num="10" subtitle_num="64" chapter_num="01" heading="Patient’s Refusal to Transfer Care.">
  <paragraph num="A.">
    <text>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:</text>
    <paragraph num="(1)">
      <text>Transfer care of the patient to a health care practitioner; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Complete the standard form developed under Regulation .10 of this chapter and:</text>
      <paragraph num="(a)">
        <text>Submit the completed form to the accepting health care practitioner; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Cease to take responsibility for the patient’s pregnancy care within 1 week after the transfer.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>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:</text>
    <paragraph num="(1)">
      <text>Call 9-1-1 and remain with the patient until emergency services personnel arrive; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Transfer care and give a verbal report of the care provided to the emergency medical services providers.</text>
    </paragraph>
  </paragraph>
</regulation>