Louisiana Administrative Code
Title 46 - PROFESSIONAL AND OCCUPATIONAL STANDARDS
Part XLV - Medical Professions
Subpart 3 - Practice
Chapter 53 - Licensed Midwives
Subchapter A - Standards of Practice
Section XLV-5315 - Unapproved Practice [Formerly Section 5361]
Universal Citation: LA Admin Code XLV-5315
Current through Register Vol. 50, No. 9, September 20, 2024
A. The licensed midwife practitioner shall provide care only to clients determined by physician evaluation and examination to be at low or normal risk of developing complications during pregnancy and child birth.
B. The midwife shall not knowingly accept or thereafter maintain responsibility for the prenatal or intrapartum care of a woman who:
1. has had a
previous cesarean section or other known uterine surgery such as hysterotomy or
myomectomy. This prohibition shall not apply to a midwifes continued perinatal
care of a woman who has had no more than one prior cesarean section, provided
that arrangements have been made with a physician for a planned hospital
delivery at the onset of labor. The midwife shall contact the physician and
confirm and document the arrangements for a planned hospital delivery in the
clients chart. Within ten days of delivery, a midwife shall report to the board
in writing any instance where midwifery services were provided under
§5315. B.1 of this
Chapter to a client who delivered outside of a planned hospital
delivery;
2. has a history of
difficult to control hemorrhage with previous deliveries;
3. has a history of thromboembolus, deep vein
thromboembolus, or pulmonary embolism;
4. is prescribed medication for diabetes, or
has hypertension, Rh disease isoimmunization with positive titer, active
tuberculosis, active syphilis, active gonorrhea, HIV positive or is otherwise
immunocompromised, epilepsy, hepatitis, heart disease, kidney disease, or blood
dyscrasia;
5. contracts primary
genital herpes simplex during the pregnancy or manifests active genital herpes
during the last four weeks of pregnancy;
6. has a contracted pelvis;
7. has severe psychiatric illness or a
history of severe psychiatric illness in the six month period prior to
pregnancy;
8. has been prescribed
narcotics in excess of three months or is addicted to narcotics or other
drugs;
9. ingests more than 2
ounces of alcohol or 24 ounces of beer a day on a regular day or participates
in binge drinking;
10. smokes 20
cigarettes or more per day, and is not likely to cease in pregnancy;
11. has a multiple gestation;
12. has a fetus of less than 37 weeks
gestation at the onset of labor;
13. has a gestation beyond 42 weeks by dates
and examination;
14. has a fetus in
any presentation other than vertex at the onset of labor;
15. is a primigravida with an unengaged fetal
head in active labor, or any woman who has rupture of membranes with unengaged
fetal head, with or without labor;
16. has a fetus with suspected or diagnosed
congenital anomalies that may require immediate medical intervention;
17. has preeclampsia;
18. has a parity greater than five with poor
obstetrical history; or
19. is
younger than 16 or a primipara older than 40.
AUTHORITY NOTE: Promulgated in accordance with R.S.37:1270 and 37:3241-3259.
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