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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