Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 264 - BIRTH CENTER LICENSING CODE › Subpart A - GENERAL REQUIREMENTS › Section 264.1550 - Admission Protocols for Acceptance of Birth Center Clients

Current through Register Vol. 48, No. 28, July 12, 2024
a) Only clients
				whose births are planned to occur following a normal, uncomplicated, and
				low-risk pregnancy may be allowed to receive services at the birth center.
				Clients must meet the criteria for birth center admission that are consistent
				with accreditation standards and the certified nurse midwife's or physician's
				scope of practice and with requirements of this Section.
b) No general, spinal/epidural, or regional
				anesthesia may be administered at the birth center.
c) Any pregnant person walk-in who is beyond
				32 weeks of gestation and is in labor, and who has not previously been approved
				for admission, shall be immediately transported to a hospital.
d)
An obstetrician, family
				practitioner
(family physician) or physician,
certified nurse
				midwife, or licensed certified professional midwife shall attend each person in
				labor from the time of admission through birth and throughout the immediate
				postpartum period. Attendance may be delegated only to another physician a
				certified nurse midwife, or a licensed certified professional midwife
.
				(Section 25(c) of the Act)
e)
				Criteria for approval for admission shall be in writing.
f) Each birth center shall establish a
				written risk assessment that shall be completed prior to admission for each
				client and included in the client's clinical record. The assessment must
				include a detailed medical history, a physical examination, family
				circumstances, and other social and psychological factors.
g) A physician, certified nurse midwife, or a
				licensed certified professional midwife shall determine the general health and
				complete a risk assessment of the client per requirements in subsection (f),
				using the following criteria for exclusion as a birth center client. These
				criteria shall be considered for all clients prior to acceptance for birth
				center services and throughout the pregnancy for continuation of services. The
				clinical director shall use professional judgment consistent with
				recommendations in the Guidelines for Perinatal Care, Standards for Birth
				Centers, and Indicators of Compliance with Standards for Birth Centers to make
				determinations of the criteria for exclusion for delivery at the birth center.
1) Pre-pregnancy body mass index of less than
				18 or greater than 40.
2) Medical
				risk factors, including, but not limited to:
A) Chronic hypertension not controlled by
				medication;
B) Elevated blood
				glucose levels unresponsive to dietary management;
C) Positive HIV antibody test; or
D) Current drug or alcohol substance use
				disorder.
3) Obstetrical
				risk factors, including but not limited to:
A)
				Two or more prior cesarean sections (a client with a single prior cesarean may
				be admitted subject to conditions in subsection (h));
B) History of gynecologic uterine wall
				surgery in which the uterine cavity was entered; or
C) History of manual removal of a
				placenta.
4)
				Prenatal/delivery risk factors, including but not limited to:
A) Documented low-lying placenta in an
				individual with a history of previous cesarean delivery;
B) Anemia resistant to supplemental
				therapy;
C) Documented placental
				anomaly;
D) Lie other than vertex
				at term;
E)
				Pre-eclampsia/gestational hypertension (as defined by current ACOG
				standards);
F) Multiple
				gestation;
G) Premature labor at
				less than 36 weeks (client may return to the birth center if not delivered at
				37 weeks);
H) Rupture of membranes
				prior to the 37th week gestation;
I) Gestation beyond 42 weeks by reliable
				confirmed dates;
J)
				Isoimmunization, Rh-negative sensitized, positive titers, or any other positive
				antibody titer, which may have a detrimental effect on the childbearing
				individual or fetus;
K) Suspected
				deep vein thrombosis;
L) Placental
				abruption or previa;
M) Dead
				fetus;
N) Known fetal anomalies
				that may be affected by the site of birth; or
O) Primary genital herpes infection in
				pregnancy.