24.111.610    HIGH RISK PREGNANCY: CONDITIONS REQUIRING PRIMARY CARE BY A PHYSICIAN

(1) If the following conditions are present, the licensed direct-entry midwife shall not accept the woman as a client:

(a) chronic medical problems:

(i) cardiac disease (Class II or greater);

(ii) diabetes mellitus requiring medication;

(iii) essential hypertension (greater than 140/90 Hg, not controlled by medication);

(iv) hemoglobinopathies:

(v) renal disease (chronic, diagnosed, not urinary tract infection);

(vi) thrombophlebitis or pulmonary embolism;

(vii) epilepsy currently on medication;

(viii) current severe psychiatric condition requiring medication within a six-month period prior to pregnancy;

(ix) active: tuberculosis, syphilis, gonorrhea, hepatitis, AIDS, genital herpes at onset of labor;

(x) current drug or alcohol abuse/dependency;

(xi) current malignant disease;

(xii) chronic obstructive pulmonary disease, except for controlled asthma.

(b) current pregnancy related conditions:

(i) pregnancy induced hypertension (preeclamptic or eclamptic symptoms);

(ii) premature labor (before 36 1/2 weeks gestation verified estimated date of delivery by dates and physical exam);

(iii) placental abruption;

(iv) placenta previa at onset of labor;

(v) has a fetus in any presentation other than vertex at onset of labor;

(vi) multiple gestation;

(vii) contracts primary genital herpes in the first trimester;

(viii) Rh sensitization.

(c) previous obstetrical history:

(i) previous Rh sensitization;

(ii) history of inverted uterus.

 

History: 37-27-105, MCA; IMP, 37-27-105, MCA; NEW, 1993 MAR p. 1639, Eff. 7/30/93; AMD, 1995 MAR p. 2684, Eff. 12/8/95; TRANS, from Commerce, 2001 MAR p. 1642; AMD, 2023 MAR p. 886, Eff. 8/26/23.