Code of Colorado Regulations
700 - Department of Regulatory Agencies
739 - Division of Professions and Occupations - Office of Direct-Entry Midwifery Registration
4 CCR 739-1 - MIDWIVES REGISTRATION RULES AND REGULATIONS
Section 4 CCR 739-1.12 - STANDARDS FOR VAGINAL BIRTH AFTER CESAREAN SECTION (VBAC)

Universal Citation: 4 CO Code Regs 739-1 ยง 12

Current through Register Vol. 47, No. 17, September 10, 2024

The purpose of this Rule is to establish parameters for VBAC clients seeking midwifery care during pregnancy in order to safeguard the client's welfare pursuant to section 12-225-106(11), C.R.S.

A. A direct- entry midwife shall not assume primary responsibility for prenatal care and birth attendance for women who have had a previous cesarean section unless all of the following conditions are met:

1. All prospective VBAC women shall sign an informed consent statement, which shall be retained in the client's records and include the following:
a. VBAC educational information including history of VBAC and client's own personal information;

b. Associated risks and benefits of VBAC at home;

c. A workable hospital transport plan;

d. Alternatives to VBAC at home; and

e. Other information as required by the Director.

2. A workable hospital transport plan must be established for home VBAC. The plan shall be in writing and include:
a. Place of birth within 30 minutes of transport to the nearest hospital or emergency medical center able to perform an emergency cesarean;

b. Readily available emergency numbers for the nearest hospital or emergency medical center; and

c. Provision for phone contact with the nearest hospital or emergency medical center prior to any transport notifying the destination that transport is in progress.

3. There has been at least 18 months from the client's cesarean delivery to the due date of the current pregnancy.

4. The client with 2 or more cesarean deliveries has also had a vaginal delivery since the last cesarean delivery.

B. The direct-entry midwife shall obtain prior client cesarean written records, shall analyze the indication for the previous cesarean, and retain the records along with a written assessment of the physical and emotional considerations in the client's files. If the direct-entry midwife is unable to obtain the written records, the direct-entry midwife shall not retain the woman as a client.

C. Records that show a previous classical uterine/vertical incision or any previous uterine surgery which required an incision into the uterine fundus are a contraindication to VBAC at home and shall require immediate transfer of care of the client.

D. Direct-entry midwife shall not induce or augment labor by the use of chemicals or herbal supplements or nipple stimulation.

E. A direct-entry midwife shall be present and manage the VBAC delivery from the onset of active labor throughout the immediate postpartum period.

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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