<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".10" citation="COMAR 10.64.01.10" title_num="10" subtitle_num="64" chapter_num="01" heading="Plan of Care.">
  <paragraph num="A.">
    <text>A licensed direct-entry midwife shall develop a general written plan for:</text>
    <paragraph num="(1)">
      <text>Emergency transfer of a patient, a newborn, or both;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Transport of a newborn to a newborn nursery or neonatal intensive care nursery; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Transport of a patient to an appropriate hospital with a labor and delivery unit.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The Committee shall review and recommend approval to the Board of the plan required under §A of this regulation.</text>
  </paragraph>
  <paragraph num="C.">
    <text>The plan required under §A of this regulation shall be provided to any hospital identified in the plan approved by the Committee.</text>
  </paragraph>
  <paragraph num="D.">
    <text>In addition to the general written plan required under §A of this regulation, a licensed direct-entry midwife shall prepare a plan that is specific to each patient and share the plan with the patient.</text>
  </paragraph>
  <paragraph num="E.">
    <text>The plan required under §D of this regulation shall:</text>
    <paragraph num="(1)">
      <text>Include procedures and processes to be undertaken in the event of an emergency for the mother, the newborn, or both;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Identify the hospital nearest to the address of the planned home birth that has a labor and delivery unit;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Include a care plan for the newborn; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Identify the pediatric health care practitioner who will be notified after delivery in accordance with Regulation .02 of this chapter to receive the transfer of care of the newborn.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Each direct-entry midwife shall use the standard form approved by the Board for all cases in which a transfer occurs during prenatal care, labor, or postpartum.</text>
  </paragraph>
  <paragraph num="G.">
    <text>After a decision to transport a patient has been made, the licensed direct-entry midwife shall:</text>
    <paragraph num="(1)">
      <text>Call the receiving health care provider;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Inform the health care provider of the incoming patient;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Accompany the patient to the hospital; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>On arrival at the hospital, provide to the staff of the hospital;</text>
      <paragraph num="(a)">
        <text>The standard form developed under §D of this regulation;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The complete medical records of the patient and newborn; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A verbal summary of the care provided to the patient and newborn by the licensed direct-entry midwife.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>