Code of Massachusetts Regulations
105 CMR - DEPARTMENT OF PUBLIC HEALTH
Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers
Section 142.100 - Definitions

A Birth Center is a home-like facility where low risks births are planned to occur following normal, uncomplicated pregnancy. A birth center has sufficient space to accommodate participating family members and support people of the women's choice. A Birth Center provides professional midwifery practice to childbearing women during pregnancy, birth, and puerperium and to the infant during the immediate newborn period by nurse-midwives or by an obstetrician or family practitioner with obstetrical privileges in a nearby hospital licensed in Massachusetts or operated by the Commonwealth. A Birth Center has specified access to acute care obstetric and newborn services.

Clinic means any entity, however organized, whether conducted for profit or not for profit, which is advertised, announced, established, or maintained for the purpose of providing ambulatory medical, surgical, dental, physical rehabilitation or mental health. In addition, Clinic shall include any entity, however organized, whether conducted for profit or not for profit, which is advertised, announced, established, or maintained under a name which includes the word Clinic, "dispensary", or "institute", and which suggests that ambulatory medical, surgical, dental, physical rehabilitation or mental health are rendered therein. With respect to any entity which is not advertised, announced, established, or maintained under one of the names in the preceding sentence, Clinic shall not include a medical office building, or one or more practitioners engaged in a solo or group practice, whether conducted for profit or not for profit, and however organized, so long as such practice is wholly owned and controlled by one or more of the practitioners so associated, or, in the case of a not for profit organization, its only members are one or more of the practitioners so associated or a clinic established solely to provide service to employees or students of such corporation or institution. No matter how the clinic is named, Clinic shall not include a clinic conducted by a hospital licensed under M.G.L. c. 111, § 51 or by the federal government, the commonwealth, or a local health department.

Commissioner means the Commissioner of the Department of Public Health or her or his designee.

Controlled Substance means a drug, substance, or immediate precursor in any schedule or class referred to in the Controlled Substances Act M.G.L. c. 94C.

Critical Congenital Heart Disease means a group of defects that cause severe and life-threatening symptoms and require intervention within the first days or first year of life.

Department means the Massachusetts Department of Public Health.

Free-standing Birth Center means a birth center which is not maintained and operated by a hospital. For purposes of licensure, a free-standing birth center is a clinic.

Hospital means any institution, however named, whether conducted for charity or for profit, which is advertised, announced, established or maintained for the purpose of caring for persons admitted thereto for diagnosis, medical, surgical or restorative treatment which is rendered within said institution.

Hospital-affiliated Birth Center means a birth center which is maintained and operated by a hospital. The birth center must be nearby but not be physically attached in any manner, including connection by corridors, to any other hospital services including the obstetrics service. A birth center is not a birth room or birthing suite or other short stay in-patient service.

Hospital Birth Room, also known as a birthing suite, means a room in or immediately adjacent to the labor and delivery room suite of a hospital where a low risk, normal, full term woman is allowed to labor and deliver her infant, and recover after delivery with her infant.

Licensed Nurse means an individual registered as a nurse under M.G.L. c. 112, § 74 or licensed as a practical nurse under M.G.L. c. 112, § 74A.

Nearby means within ten minutes normal driving time of a hospital, or otherwise reasonably accessible to a hospital as determined by the Department.

Nurse-midwife means an individual licensed by the Board of Registration in Nursing under M.G.L. c. 112, § 74 and authorized to practice as a nurse-midwife pursuant to 244 CMR 4.00: Advanced Practice Registered Nursing.

Physician means an individual registered by the Board of Registration in Medicine under M.G.L. c. 112, § 2 as a qualified physician.

Professional Midwifery Practice means the independent management of care of essentially normal newborns and low risk women, antepartally, intrapartally, and postpartally occurring within a health care system which provides for medical consultation, collaborative management, or referral and is in accord with the Functions, Standards, and Qualifications for Nurse-Midwifery Practice as defined by the American College of Nurse-midwives. The nurse-midwife, or physician provides care for the low risk mother during pregnancy and stays with her during labor from the time of admission to the birth center through the immediate post-partum period providing continuous physical and emotional support, evaluating progress, and assisting the woman in labor and delivery. Care includes evaluation and provision of immediate care to the normal newborn. The qualified midwife or physician provides assistance to the mother in caring for herself and her infant; in adjusting to the home situation and the new child; and in providing family planning. The nurse midwife or physician teaches, interprets and provides support as an integral part of his or her service.