20:86:03:04Conditions

for which a maternal transport to hospital shall be facilitated. A certified professional midwife shall facilitate the immediate transport of a client to a hospital for emergency care if the client has any of the following disorders, diagnosis, conditions or symptoms: (1) Infection during labor or immediately postpartum where maternal temperature is above 100.8 degrees Fahrenheit for two consecutive readings in one hour and one or more of the following are present: (a) Foul smelling amniotic fluid; (b) Shaking; (c) Chills; or (d) Elevated pulse; (2) Suggestion of fetal jeopardy, such as any abnormal bleeding (with or without abdominal pain), evidence of placental abruption, thick meconium , or abnormal fetal heart tones with non-reassuring patterns where birth is not imminent; (3) Inability to obtain fetal heart tones after 20 weeks gestation or anytime later in pregnancy; (4) Noncephalic presentation at the onset of labor or rupture of membranes, whichever occurs first, unless birth is imminent; (5) Second stage labor after three hours without adequate progress, and third stage labor after one hour without adequate progress; (6) Current spontaneous preterm labor; (7) Current preterm premature rupture of membranes; (8) Signs of pre-eclampsia or eclampsia; (9) Current hypertensive disease of pregnancy; (10) Continuous uncontrolled bleeding; (11) Suspected placenta accreta; (12) Hemorrhage not responsive to treatment; (13) Unresolved maternal shock; (14) Cord prolapse; (15) Active herpes during labor; (16) Transverse in labor; (17) Excessive antepartum and intrapartum painless vaginal bleeding; (18) Cardiac arrest; (19) Delivery injuries to the bladder or bowel including third and fourth degree lacerations; (20) Seizures; (21) Uncontrolled vomiting; (22) Coughing or vomiting of blood; (23) Severe chest pain or cardiac irregularities; (24) Apnea; (25) Persistent uterine atony; (26) Uterine inversion; (27) Indications of infection in the immediate postpartum; (28) Tremors, hyperactivity, or seizures; (29) Declining oxygen stats or tachypnea unable to be resolved; or (30) Client desires transport for herself or her newborn.

Source: 45 SDR 31, effective September 10, 2018.