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-5345 - Postpartum Care [Formerly Section 5327 and Section 5357]

Current through Register Vol. 50, No. 6, June 20, 2024
A. The licensed midwife practitioner shall
					 remain with the mother and infant for at least two hours postpartum, or until
					 the mother's condition is stable and the infant's condition is stable,
					 whichever is longer. Maternal stability is evidenced by normal blood pressure,
					 normal pulse, normal respirations, firm fundus, and normal lochia. Infant
					 stability is evidenced by established respirations, normal temperature, strong
					 sucking and normal heart rate.
B.
					 Immediately following delivery of the placenta, the midwife must determine that
					 the uterus is firmly contracted without excessive bleeding. The uterus should
					 be massaged firmly to stimulate contraction if relaxation is noted.
C. In case of an unsensitized Rh negative
					 mother, the midwife shall obtain a sample of cord blood from the placenta and
					 arrange for testing within 24 hours of the birth and ensure referral to a
					 physician so that the mother receives Rh immunoglobulin (Rhlg) as indicated
					 within 72 hours of delivery.
D. The
					 midwife shall provide the client with information concerning routine postpartum
					 care of the mother and infant, including information on breast-feeding, care of
					 the infants umbilical cord, and perinatal care.
E. The midwife shall recommend that the
					 parents immediately contact the pediatrician or primary care physician who will
					 be assuming care for the infant to arrange for a neonatal examination within 72
					 hours or sooner if it becomes apparent that the newborn requires medical
					 attention for problems associated with, but not limited, to congenital or other
					 anomalies. The midwife shall provide the doctor with her written summary of
					 labor, delivery, and assessment of the newborn and shall be available to
					 consult with the doctor concerning the infant's condition.
F. The midwife shall make a postpartum visit
					 within 36 hours of birth, with further visits as necessary. The purpose of
					 these contacts is to ascertain that the infant is alert, has good color, is
					 breathing well, and is establishing a healthy pattern of waking, feeding, and
					 sleeping and that the mother is not bleeding excessively, has a firm fundus,
					 does not have a fever or other signs of infection, is voiding properly, and is
					 establishing successful breastfeeding. In the event that any complications
					 arise, the midwife shall consult with a physician or other appropriate health
					 care provider or shall ensure that the client contacts her own
					 physician.
G. The midwife may
					 conduct a postpartum office visit not later than six weeks postpartum, to
					 include a recommendation for rubella vaccine if indicated, counseling
					 concerning contraception and answering any other questions that have arisen.
					 Alternatively, the client may be referred back to her primary care physician or
					 other health care provider for this care.
H. The midwife shall encourage the mother to
					 have a postpartum evaluation conducted by a physician within two to six weeks
					 after delivery.
AUTHORITY NOTE:
						Promulgated in accordance with
						R.S.
						37:1270 and
						37:3241-3259.