Cal. Code Regs. tit. 15 § 3999.309

Current through Register 2024 Notice Reg. No. 50, December 13, 2024

Section 3999.309 - Patient Care During Pregnancy and Childbirth

(a) The California Department of Corrections and Rehabilitation (CDCR) shall provide obstetrical (OB) services, to include care for women with high-risk pregnancies. CDCR shall provide OB services 24 hours per day including, but not limited to:

(1) Emergency treatment and management of preterm and precipitous delivery.

(2) Hospital, surgical, and neonatal services.

(3) Social and educational services pertaining to pregnancy, childbirth, and health promotion.

(b) CDCR shall conduct a health screening, including a pregnancy screening, for all female incarcerated persons upon reception.

(c) All newly identified pregnant patients shall be referred for transfer to a designated institution for pregnant patients.

(d) The Primary Care Provider (PCP) shall evaluate patients within seven calendar days of self-reporting a suspected pregnancy or when pregnancy is suggested by the patient's physical appearance, or signs and symptoms of pregnancy are present.

(e) Upon confirmation of pregnancy, the Primary Care Team shall provide or coordinate OB and health care services to include a written plan of care.

(1) A patient may request to receive medical services from the physician of her choice who is credentialed and trained in obstetrics. Any expenses incurred by the services of a non-CDCR physician shall be the responsibility of the patient.

(f) Pregnant patients shall be provided the following:

(1) An initial OB visit scheduled to occur within seven days of pregnancy diagnosis.

(2) Diagnostic studies ordered as medically necessary.

(3) The option to be tested for human immunodeficiency virus.

(4) Education by the PCP or Obstetrician regarding the patient's choice of pregnancy options, including, but not limited to:

(A) Continuing pregnancy and childcare plans.

(B) Adoption.

(C) Termination services.

(D) Emergency contraceptives.

(E) Obtaining pregnancy information pamphlets or other pertinent educational material.

(g) Pregnant patients shall be prescribed or issued:

(1) Prenatal vitamins (which contain iron and folic acid).

(2) Dietary supplementation pursuant to section 3050(a)(3).

(3) Lower bunk and lower tier housing if housed in a multi-tier housing unit, and any other necessary medical clearances or restrictions in their third trimester or earlier, if clinically indicated.

(4) Dental care for patients in the second trimester of gestation shall be provided pursuant to section 3999.367(t).

(h) Unless otherwise indicated by the Obstetrician, pregnant patients shall be scheduled for their OB visits as follows:

(1) Every four weeks in the first trimester and up to 24-26 weeks gestation.

(2) Every three weeks up to 30 weeks gestation.

(3) Every two weeks up to 36 weeks gestation.

(4) Weekly after 36 weeks gestation up to delivery.

(i) Every pregnant patient electing to continue her pregnancy shall be referred to a Medical Social Worker for case management to discuss placement of her child and options available for placement and care of the child after delivery.

(j) If clinically appropriate, patients shall be provided opioid maintenance therapy during pregnancy.

(k) Emergency transport. A pregnant patient in labor shall be treated as an emergency and be transported immediately via ambulance.

(l) Postpartum care.

(1) Postpartum patients who deliver a child via cesarean section shall be admitted to the Outpatient Housing Unit or Correctional Treatment Center upon return to the institution.

(2) All postpartum patients who deliver a child vaginally shall be assessed to initiate postpartum care and determine appropriate housing.

(3) Patients shall be offered family planning services if their release or parole date falls within 12 to 16 weeks after delivery.

Cal. Code Regs. Tit. 15, § 3999.309

Note: Authority cited: Section 5058, Penal Code. Reference: Sections 3406, 3409 and 5054, Penal Code; and Plata v. Newsom (No. C01-1351 JST), U.S. District Court, Northern District of California.

1. New section filed 7-1-2019 as an emergency; operative 7/1/2019 (Register 2019, No. 27). Pursuant to Penal Code section 5058.3, a Certificate of Compliance must be transmitted to OAL by 12-9-2019 or emergency language will be repealed by operation of law on the following day.
2. New section refiled 12-5-2019 as an emergency; operative 12/10/2019 (Register 2019, No. 49). Pursuant to Penal Code section 5058.3, a Certificate of Compliance must be transmitted to OAL by 3-9-2020 or emergency language will be repealed by operation of law on the following day.
3. New section refiled 3-9-2020 as an emergency; operative 3/10/2020 (Register 2020, No. 11). A Certificate of Compliance must be transmitted to OAL by 6-8-2020 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 3-9-2020 order transmitted to OAL 6-8-2020 and filed 7/20/2020 (Register 2020, No. 30).
5. Change without regulatory effect amending subsection (b) filed 7-1-2024 pursuant to section 100, title 1, California Code of Regulations (Register 2024, No. 27).