Code of Maine Rules
02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
502 - BOARD OF COMPLEMENTARY HEALTH CARE PROVIDERS
Chapter 6-C - STANDARDS FOR VAGINAL BIRTH AFTER CESAREAN SECTION (VBAC)
Section 502-6-C-2 - Records and responsibilities of the Certified Professional Midwife or Certified Midwife

1. Prior to providing birth services in a home or a freestanding birth center, the Certified Professional Midwife or Certified Midwife shall obtain prior operative reports and written records from the client's previous cesarean delivery and shall analyze the indication for the previous cesarean.

A Certified Professional Midwife or Certified Midwife may not provide birth services in a home or a freestanding birth center if prior operative reports and written records cannot be obtained unless the uterine scar location can be determined by other methods.

2. Records or reports that show a previous classical uterine/vertical incision or any previous uterine surgery which required an incision into the uterus is a contraindication to VBAC at home or freestanding birth center.

3. The Certified Professional Midwife or Certified Midwife must document the client's blood group and type in the current pregnancy.

4. The Certified Professional Midwife or Certified Midwife must require a prenatal ultrasound for determination of placental location in the second or third trimester.

5. The Certified Professional Midwife or Certified Midwife may not offer or use any means of botanical or pharmacological induction for the VBAC client.

6. Fetal heart tones must be monitored and documented every 15 minutes in active labor and every 5 minutes during second stage labor.

7. The client must be monitored for signs of possible uterine rupture, including but not limited to: change in vital signs; abdominal pain; vaginal bleeding in labor; loss of fetal station; loss of engagement of fetal vertex; inability to auscultate fetal heart tones; and inability to palpate the uterine fundus. This monitoring must be documented in the client's record.

8. Labor progression during active labor and the second stage of labor must be monitored and documented. The Certified Professional Midwife or Certified Midwife must assess for adequate labor progression.

9. A licensed midwife and at least one other provider trained in the identification and management of obstetrical emergencies who holds current Neonatal Resuscitation Program certification and Basic Life Support certification must be present during active labor and VBAC birth.

10. A Certified Professional Midwife or Certified Midwife shall, after the effective date of these rules, for a period of one year on a quarterly basis, provide the Board with a written brief outcome report of each planned out-of-hospital VBAC including, weeks' gestation at delivery, whether transfer to a hospital was needed, whether delivery was accomplished out of hospital, weight and Apgar scores of the infant, and whether any maternal or neonatal morbidity or mortality occurred.

Thereafter, the data shall be reported once annually with the required data collection and reporting pursuant to 32 M.R.S. §12539(J).