Oklahoma Administrative Code
Title 310 - Oklahoma State Department of Health
Chapter 395 - Licensed Midwives
Subchapter 5 - Midwife Practice
Section 310:395-5-6 - Conditions precluding Midwifery care

Universal Citation: OK Admin Code 310:395-5-6

Current through Vol. 42, No. 1, September 16, 2024

(a) The following conditions preclude Midwifery care and the Client must be transferred to a physician, CNM, or Clinician upon diagnosis:

(1) Severe asthma;

(2) Cyanotic heart disease or presence of a prosthetic valve;

(3) New York Heart Association class two heart failure;

(4) History of cardiac surgery with an abnormal echocardiogram;

(5) Pulmonary Hypertension;

(6) Hemoglobinopathies; sickle cell disease, thalassemia;

(7) Chronic hypertension on medication or with renal or heart disease;

(8) Severe obstructive pulmonary disease;

(9) Chronic renal disease with a creatinine of greater than 1.5;

(10) Lupus;

(11) Marfan syndrome;

(12) History of intracranial injury (stroke, AV malformation, or aneurisms);

(13) Prolonged anti-coagulation;

(14) Type 1 diabetes;

(15) Severe Polyhydramnios less than 34 weeks;

(16) Triplets or greater;

(17) Monoamniotic twins;

(18) Conjoined twins;

(19) Placenta accrete;

(20) Documented placenta previa in the third trimester; the placenta shall not be previa. To determine this, in the case of documented placenta previa or marginal placenta previa in the second trimester, a third trimester ultrasound must show resolution by 36 weeks or the Client must be referred. The Client must obtain an official ultrasound report with images performed by a Registered Diagnostic Medical Sonographer (RDMS) to determine that the location of the placenta is not previa or marginal placenta previa no later 34 weeks.

(21) Uncontrolled seizure disorder;

(22) Evidence of placenta abruption;

(23) Evidence of preeclampsia/eclampsia;

(24) Active tuberculosis or other serious pulmonary pathology;

(25) Inadequately treated syphilis;

(26) Hepatic disorders (cholestasis);

(27) Uncontrolled endocrine disorders;

(28) Significant hematological disorders;

(29) Active cancer;

(30) Active alcoholism or abuse;

(31) Active drug addiction or abuse; and

(32) Positive for HIV antibody.

(b) The following conditions preclude Midwifery care and the Client must be transferred to a physician, CNM, or Clinician upon diagnosis unless the Client obtains a signed consult note from a medically relevant physician and all recommended treatments can be completed in an out of hospital setting.

(1) History of seizure disorder;

(2) History of preterm labor or cervical insufficiency;

(3) Evidence of shortened cervix;

(4) Positive for Hepatitis B;

(5) History of chronic hypertension;

(6) Isoimmunization;

(7) History of post-partum hemorrhage with concurrent anemia;

(8) History of unexplained, recurrent stillbirths or neonatal death;

(9) Severe psychiatric illness within the last six (6) months as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM);

(10) Pregnancy that extends beyond 42 weeks 0/7 days gestational age;

(11) Two or more previous cesarean deliveries unless the Client has also had a successful vaginal delivery since the last cesarean delivery;

(12) BMI over 50 at onset of pregnancy;

(13) Type 2 diabetes; and

(14) History of cardiac surgery with a normal echocardiogram within the last 12 months.

Disclaimer: These regulations may not be the most recent version. Oklahoma may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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