333-077-0150 Pharmacy and Anesthetic Services (1) In a birthing center, all medications must be prescribed, dispensed, or administered to a client within an individual clinical provider's license or scope of practice. (2) The clinical provider shall be responsible for: (a) Ensuring that a client receives the correct medication and the correct dosage. (b) Ensuring that medication prescribed to a client is accurately labeled following the requirements of the Oregon Board of Pharmacy. (c) Determining whether the pharmacy services provided under the clinical provider's license or scope of practice require that the birthing center be registered as a Dispensing Practitioner Drug Outlet with the Oregon Board of Pharmacy. (d) Ensuring the birthing center system to inventory and monitor medications meets the requirements in section (3) of this rule and complies with any requirements established by the Oregon Board of Pharmacy. (3) A birthing center shall have a system to routinely inventory and monitor all prescription and non-prescription medications, intravenous fluids, and ancillary supplies. The system shall include, but is not limited to: (a) Identification, storage, security, and reconciliation of all medications, fluids and controlled substances; (b) Storage of deteriorated, outdated, misbranded, or contaminated medications or medications otherwise unfit for use be readily identified as defective and stored in a separate location; and (c) Proper disposal of expired medications, including special prescriptions for clients who have left the birthing center. (4) Medications shall not be administered to a client unless ordered by a clinical provider or other individual authorized within the scope of their professional license to prescribe medications. Such orders shall be in writing and signed by the clinical provider or other authorized individual. An electronic signature or other authentication method is acceptable. (5) Prescription medications dispensed by a clinical provider or other individual authorized within the scope of their professional license shall be personally dispensed by the provider or other individual authorized within the scope of their professional license, unless otherwise authorized by rules of the Oregon Board of Pharmacy and the clinical provider's regulatory board. (6) A birthing center shall maintain written prescriptions or orders, signed by a clinical provider or other individual legally authorized to prescribe, for all medications administered to a client within the birthing center. (7) All non-prescription medication and nutritional supplements shall be clearly labeled with the client's name, name of medication, dosage, directions for use, and expiration date. (8) General, spinal, caudal, or epidural anesthesia shall not be administered in the birthing center. (9) Labor shall not be induced, stimulated, or augmented with any drug during the first or second stages of labor. Drugs may be administered within the individual clinical provider's scope of practice to inhibit labor, as a temporary measure, until referral or transfer of the client is complete. (10) Nitrous oxide may be prescribed and dispensed in accordance with a clinical provider's scope of practice and in accordance with the following: (a) A client must be assessed for suitability and absence of contraindications; (b) Informed consent must be obtained from the client that clearly identifies potential risks; (c) Clients must be educated in the use of the equipment and the nitrous shall be self-administered only. No assistance from birthing center staff or from other individuals is allowed; (d) The nitrous oxide concentration must not exceed 50 percent and shall be administered through a scavenging system with a demand valve in a well-ventilated room; (e) Clients self-administering nitrous oxide shall be continuously monitored for adverse effects by a trained clinical provider; (f) Equipment shall be sterilized and stored in accordance with policies adopted pursuant to OAR 333-077-0090; and (g) Staff shall be trained in the use of nitrous oxide in accordance with policies adopted pursuant to OAR 333-077-0090. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.025 History: PH 23-2025, adopt filed 11/03/2025, effective 11/03/2025