Louisiana Administrative Code › Title 46 - PROFESSIONAL AND OCCUPATIONAL STANDARDS › Part XLV - Medical Professions › Subpart 3 - Practice › Chapter 53 - Licensed Midwives › Subchapter A - Standards of Practice › Section XLV-5315 - Unapproved Practice [Formerly Section 5361]

Current through Register Vol. 50, No. 6, June 20, 2024
A. The licensed midwife practitioner shall
					 provide care only to clients determined by physician evaluation and examination
					 to be at low or normal risk of developing complications during pregnancy and
					 child birth.
B. The midwife shall
					 not knowingly accept or thereafter maintain responsibility for the prenatal or
					 intrapartum care of a woman who:
1. has had a
					 previous cesarean section or other known uterine surgery such as hysterotomy or
					 myomectomy. This prohibition shall not apply to a midwifes continued perinatal
					 care of a woman who has had no more than one prior cesarean section, provided
					 that arrangements have been made with a physician for a planned hospital
					 delivery at the onset of labor. The midwife shall contact the physician and
					 confirm and document the arrangements for a planned hospital delivery in the
					 clients chart. Within ten days of delivery, a midwife shall report to the board
					 in writing any instance where midwifery services were provided under §5315. B.1 of this Chapter to a client who delivered outside of a planned hospital
					 delivery;
2. has a history of
					 difficult to control hemorrhage with previous deliveries;
3. has a history of thromboembolus, deep vein
					 thromboembolus, or pulmonary embolism;
4. is prescribed medication for diabetes, or
					 has hypertension, Rh disease isoimmunization with positive titer, active
					 tuberculosis, active syphilis, active gonorrhea, HIV positive or is otherwise
					 immunocompromised, epilepsy, hepatitis, heart disease, kidney disease, or blood
					 dyscrasia;
5. contracts primary
					 genital herpes simplex during the pregnancy or manifests active genital herpes
					 during the last four weeks of pregnancy;
6. has a contracted pelvis;
7. has severe psychiatric illness or a
					 history of severe psychiatric illness in the six month period prior to
					 pregnancy;
8. has been prescribed
					 narcotics in excess of three months or is addicted to narcotics or other
					 drugs;
9. ingests more than 2
					 ounces of alcohol or 24 ounces of beer a day on a regular day or participates
					 in binge drinking;
10. smokes 20
					 cigarettes or more per day, and is not likely to cease in pregnancy;
11. has a multiple gestation;
12. has a fetus of less than 37 weeks
					 gestation at the onset of labor;
13. has a gestation beyond 42 weeks by dates
					 and examination;
14. has a fetus in
					 any presentation other than vertex at the onset of labor;
15. is a primigravida with an unengaged fetal
					 head in active labor, or any woman who has rupture of membranes with unengaged
					 fetal head, with or without labor;
16. has a fetus with suspected or diagnosed
					 congenital anomalies that may require immediate medical intervention;
17. has preeclampsia;
18. has a parity greater than five with poor
					 obstetrical history; or
19. is
					 younger than 16 or a primipara older than 40.