Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 502 - BOARD OF COMPLEMENTARY HEALTH CARE PROVIDERS › Chapter 6-C - STANDARDS FOR VAGINAL BIRTH AFTER CESAREAN SECTION (VBAC) › Section 502-6-C-2 - Records and responsibilities of the Certified Professional Midwife or Certified Midwife

Current through 2024-29, July 17, 2024
1. Prior to
				providing birth services in a home or a freestanding birth center, the
				Certified Professional Midwife or Certified Midwife shall obtain prior
				operative reports and written records from the client's previous cesarean
				delivery and shall analyze the indication for the previous cesarean.
A Certified Professional Midwife or Certified Midwife may not
				  provide birth services in a home or a freestanding birth center if prior
				  operative reports and written records cannot be obtained unless the uterine
				  scar location can be determined by other methods.
2. Records or reports that show a previous
				classical uterine/vertical incision or any previous uterine surgery which
				required an incision into the uterus is a contraindication to VBAC at home or
				freestanding birth center.
3. The
				Certified Professional Midwife or Certified Midwife must document the client's
				blood group and type in the current pregnancy.
4. The Certified Professional Midwife or
				Certified Midwife must require a prenatal ultrasound for determination of
				placental location in the second or third trimester.
5. The Certified Professional Midwife or
				Certified Midwife may not offer or use any means of botanical or
				pharmacological induction for the VBAC client.
6. Fetal heart tones must be monitored and
				documented every 15 minutes in active labor and every 5 minutes during second
				stage labor.
7. The client must be
				monitored for signs of possible uterine rupture, including but not limited to:
				change in vital signs; abdominal pain; vaginal bleeding in labor; loss of fetal
				station; loss of engagement of fetal vertex; inability to auscultate fetal
				heart tones; and inability to palpate the uterine fundus. This monitoring must
				be documented in the client's record.
8. Labor progression during active labor and
				the second stage of labor must be monitored and documented. The Certified
				Professional Midwife or Certified Midwife must assess for adequate labor
				progression.
9. A licensed midwife
				and at least one other provider trained in the identification and management of
				obstetrical emergencies who holds current Neonatal Resuscitation Program
				certification and Basic Life Support certification must be present during
				active labor and VBAC birth.
10. A
				Certified Professional Midwife or Certified Midwife shall, after the effective
				date of these rules, for a period of one year on a quarterly basis, provide the
				Board with a written brief outcome report of each planned out-of-hospital VBAC
				including, weeks' gestation at delivery, whether transfer to a hospital was
				needed, whether delivery was accomplished out of hospital, weight and Apgar
				scores of the infant, and whether any maternal or neonatal morbidity or
				mortality occurred.
Thereafter, the data shall be reported once annually with the
				  required data collection and reporting pursuant to
				  32
				  M.R.S. §12539(J).