1. The director of a freestanding birthing
center shall establish:
(a) Criteria for
determining whether the risk of a pregnancy is too high for a person to give
birth in the freestanding birthing center. Those criteria must align with the
risk factors prescribed in the publication adopted by reference in section
12.
(b) Protocols for determining
whether a pregnant person is progressing normally through active
labor.
2. A freestanding
birthing center may allow a pregnant person to give birth at the freestanding
birthing center if:
(a) The pregnant person
is eligible to give birth in the freestanding birthing center when evaluated
using the criteria established pursuant to paragraph (a) of subsection
1;
(b) Except as otherwise provided
in subsection 3, the pregnant person is not less than 15 years of age or
greater than 40 years of age;
(c)
The gestational age of the pregnancy is not less than 252 days and not greater
than 294 days;
(d) There is no
medical, obstetric, fetal or neonatal condition that would preclude a safe
labor, birth and postpartum period at the freestanding birthing center,
including, without limitation:
(1) No
previous history of major surgery of the uterine wall or more than one previous
cesarean birth; and
(2) No
clinically significant signs or symptoms of:
(I) Chronic hypertension with or without
medications;
(II) Polyhydramnios or
oligohydramnios;
(VI) Retardation of
intrauterine growth;
(VII)
Meconium-stained amniotic fluid associated with signs of fetal intolerance of
labor;
(VIII) Fetal intolerance of
labor;
(IX) Active substance use
disorder;
(XI) Medication dependent
diabetes; or
(XII) Anemia that is
not resolved with treatment;
(e) During active labor, the pregnant person
does not demonstrate clinically significant signs or symptoms of:
(1) Intrapartum hemorrhage;
(2) Active herpes simplex II of the genitals;
or
(3) Malpresentation of the
fetus, including, without limitation, breech presentation;
(f) The pregnant person is progressing
normally through active labor, as determined by the clinical providers of the
freestanding birthing center in accordance with the protocols established
pursuant to paragraph (b) of subsection 1;
(g) The membranes of the pregnant person did
not rupture more than 48 hours before the admission of the pregnant person to
the freestanding birthing center;
(h) The pregnant person shows no evidence of
a significant infection for which treatment is beyond the scope of practice of
the clinical provider who will be responsible for the care of the pregnant
person; and
(i) The pregnancy is
appropriate for a setting where anesthesia is limited to a local infiltration
of the perineum, a pudendal block or the use of nitrous oxide for pain relief
during labor.
3. The
director of a freestanding birthing center may allow a pregnant person who does
not meet the requirements of paragraph (b) of subsection 2 to give birth at the
freestanding birthing center if, after reviewing the specific case of the
pregnant person, the director determines that it is safe for the pregnant
person to give birth at the freestanding birthing center.
Added
to NAC by Bd. of Health by
R062-21A,
eff. 9/8/2022
NRS
439.200,
449.0302, as amended by section
16.5 of Assembly Bill No. 287, chapter 517, Statutes of Nevada 2021, at page
3437
