Code of Colorado Regulations
1000 - Department of Public Health and Environment
1011 - Health Facilities and Emergency Medical Services Division (1011, 1015 Series)
6 CCR 1011-1 Chapter 22 - BIRTH CENTERS
Part 8 - CLIENT CARE
Universal Citation: 1000 CO Code Regs 8
Current through Register Vol. 48, No. 6, March 25, 2025
8.1 The facility shall have written policies and procedures regarding the provision of comprehensive perinatal care for low-risk pregnancy, newborn care, and referral of high-risk pregnancy, consistent with current standards of practice, as developed by the clinical director and approved by the governing body. Policies and procedures shall respect cultural diversity, be in accordance with national standards for midwifery care, and include, but not be limited to:
(A) Client education, including orientation to the philosophy of care and the scope of services of the facility.
(B) Continuous risk screening that requires:
(1) Screening processes with written criteria that ensure the facility registers and admits only clients with low-risk pregnancies.
(2) Routine evaluation of clients by clinical providers throughout pregnancy to ensure that their pregnancy remains low risk and appropriate for facility services.
(3) Protocols for referring high-risk clients and newborns with conditions outside of the facility's scope of care to appropriate providers, consistent with the facility's policies and procedures developed in accordance with Part 5.2(E) of these rules.
(C) Lactation and infant feeding supportive practices.
(D) The availability of clinical providers 24 hours per day, 7 days per week.
8.2 Provision of Care
(A) All persons registered as clients of the facility shall be under the care of clinical providers.
(B) Prenatal Care
(1) Clients shall be educated on the following, at a minimum:
(a) Anticipated changes during pregnancy.
(b) The signs of preterm labor.
(c) Preparation for labor and delivery, including pain management and potential obstetrical complications and procedures.
(d) Feeding options and care of the newborn, including infant safe sleep practices.
(e) Signs of depression during pregnancy and after childbirth.
(f) Preparation needed prior to discharging the client and the newborn following delivery, including referrals associated with ensuring the continuity of care.
(2) Each client shall have a plan of care developed by their team of clinical providers. The plan shall identify the care to be provided and the need for postpartum services. The client shall be involved in reassessments and revisions of the plan that may be required.
(3) Each client shall undergo prenatal testing in accordance with professional standards of care and all applicable state laws and regulations.
(C) Care During Labor and Delivery
(1) The facility shall ensure compliance with informed consent requirements in 6 CCR 1011-1, Chapter 2, for each client upon their arrival to the facility.
(2) The facility shall ensure regular and appropriate assessment of the client and fetus is provided throughout labor by staff with appropriate clinical privileges, in accordance with national standards.
(3) Anesthesia shall be limited to local anesthesia for episiotomies and repair of lacerations. Such anesthesia shall only be administered by a clinical provider or auxiliary staff member whose clinical privileges include such administration.
(4) The facility may provide nitrous oxide for client use as an analgesic, in compliance with national standards.
(D) Postpartum Care. Care during the postpartum period shall include, but not be limited to:
(1) Postpartum Client
(a) Postpartum physical assessments and follow up care.
(b) Screening and referral for postpartum depression.
(2) Newborn Client
(a) Newborn assessments and follow up care.
(b) Eye prophylaxis in accordance with Section 25-4-301, C.R.S.
(c) Newborn screenings in accordance with current standards of practice, Section 25-4-1001, et seq., C.R.S., and state regulations.
(i) If the facility does not provide newborn hearing screening, it shall provide information regarding where parents may have their infants' hearing screened and the importance of such screening.
(ii) For the purposes of compliance with Section 25-4-1004.3, C.R.S., critical congenital heart defect screening performed by the facility between 24 and 48 hours post-birth shall be considered to have been performed prior to the newborn's release from the birth center.
(iii) For the purposes of compliance with 5 CCR 1004-4, Part 2.2.1.2, blood specimens collected between 24 and 48 hours post-birth shall be considered to have been collected prior to the newborn's discharge from the birth center.
(d) Any newborn identified with abnormalities shall be referred for appropriate follow up, in accordance with facility policy. The facility shall transfer birth and newborn records to the care provider(s) upon request.
8.3 If client care deviates from the facility's policies and procedures, the facility shall document the reason for the deviation in the client's record.
Disclaimer: These regulations may not be the most recent version. Colorado may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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