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;
(III) Abruptio
placenta;
(IV)
Chorioamnionitis;
(V) Multiple
gestation;
(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;
(X) Placenta
previa;
(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
