(Section scheduled to be repealed on January 1, 2027) Sec. 70. Scope of practice. (a) A licensed certified professional midwife shall: (1) offer each client routine prenatal care and testing in accordance with current American College of Obstetricians and Gynecologists guidelines; (2) provide all clients with a plan for 24 hour on-call availability by a licensed certified professional midwife, certified nurse midwife, or licensed physician throughout pregnancy, intrapartum, and 6 weeks postpartum; (3) provide clients with labor support, fetal monitoring, and routine assessment of vital signs once active labor is established; (4) supervise delivery of infant and placenta, assess newborn and maternal well-being in immediate postpartum, and perform an Apgar score assessment; (5) perform routine cord management and inspect for an appropriate number of vessels; (6) inspect the placenta and membranes for completeness; (7) inspect the perineum and vagina postpartum for lacerations and stabilize if necessary; (8) observe the childbearing individual and newborn postpartum until stable condition is achieved, but in no event for less than 2 hours; (9) instruct the childbearing individual, spouse, and other support persons, both verbally and in writing, of the special care and precautions for both the childbearing individual and newborn in the immediate postpartum period; (10) reevaluate maternal and newborn well-being within 36 hours of delivery; (11) notify a pediatric health care professional within 72 hours after delivery; (12) use universal precautions with all biohazard materials; (13) ensure that a birth certificate is accurately completed and filed in accordance with the Department of Public Health; (14) offer to obtain and submit a blood sample in accordance with the recommendations for metabolic screening of the newborn; (15) offer an injection of vitamin K for the newborn in accordance with the indication, dose, and administration route as authorized in subsection (b); (16) within one week of delivery, offer a newborn hearing screening to every newborn or refer the parents to a facility with a newborn hearing screening program; (17) within 2 hours of the birth, offer the administration of antibiotic ointment into the eyes of the newborn, in accordance with the Infant Eye Disease Act; and (18) maintain adequate antenatal and perinatal records of each client and provide records to consulting licensed physicians and licensed certified nurse midwives, in accordance with regulations promulgated under the Health Insurance Portability and Accountability Act of 1996. (b) A licensed certified professional midwife may obtain and administer the following during the practice of midwifery: (1) oxygen for the treatment of fetal distress; (2) eye prophylactics, either 0.5% erythromycin ophthalmic ointment or 1% tetracycline ophthalmic ointment for the prevention of neonatal ophthalmia; (3) oxytocin, pitocin, or misoprostol as a postpartum antihemorrhagic agent; (4) methylergonovine or methergine for the treatment of postpartum hemorrhage; (5) vitamin K for the prophylaxis of hemorrhagic disease of the newborn; (6) Rho (D) immune globulin for the prevention of Rho (D) sensitization in Rho (D) negative individuals; (7) intravenous fluids for maternal stabilization, including lactated Ringer's solution, or with 5% dextrose unless unavailable or impractical, in which case 0.09% sodium chloride may be administered; (8) administer antibiotics as prophylactic for GBS in accordance with current ACOG protocols as provided by Department rule; (9) ibuprofen for postpartum pain relief; (10) lidocaine injection as a local anesthetic for perineal repair; and (11) sterile water subcutaneous injections as a non-pharmaceutical form of pain relief during the first and second stages of labor. The Department may approve by rule additional medications, agents, or procedures based upon updated evidence-based obstetrical guidelines or based upon limited availability of standard medications or agents. (c) A licensed certified professional midwife shall plan for at least 2 licensed certified professional midwives or a licensed certified professional midwife and a midwife assistant or student midwife to be present at all out-of-hospital births. testing in accordance with current American College of Obstetricians and Gynecologists guidelines; on-call availability by a licensed certified professional midwife, certified nurse midwife, or licensed physician throughout pregnancy, intrapartum, and 6 weeks postpartum; monitoring, and routine assessment of vital signs once active labor is established; newborn and maternal well-being in immediate postpartum, and perform an Apgar score assessment; an appropriate number of vessels; completeness; lacerations and stabilize if necessary; postpartum until stable condition is achieved, but in no event for less than 2 hours; other support persons, both verbally and in writing, of the special care and precautions for both the childbearing individual and newborn in the immediate postpartum period; within 36 hours of delivery; within 72 hours after delivery; materials; completed and filed in accordance with the Department of Public Health; accordance with the recommendations for metabolic screening of the newborn; in accordance with the indication, dose, and administration route as authorized in subsection (b); hearing screening to every newborn or refer the parents to a facility with a newborn hearing screening program; administration of antibiotic ointment into the eyes of the newborn, in accordance with the Infant Eye Disease Act; and records of each client and provide records to consulting licensed physicians and licensed certified nurse midwives, in accordance with regulations promulgated under the Health Insurance Portability and Accountability Act of 1996. ophthalmic ointment or 1% tetracycline ophthalmic ointment for the prevention of neonatal ophthalmia; antihemorrhagic agent; of postpartum hemorrhage; disease of the newborn; (D) sensitization in Rho (D) negative individuals; including lactated Ringer's solution, or with 5% dextrose unless unavailable or impractical, in which case 0.09% sodium chloride may be administered; accordance with current ACOG protocols as provided by Department rule; perineal repair; and non-pharmaceutical form of pain relief during the first and second stages of labor.
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