Section 142.650 - Use of Medications(A) Controlled substances may be administered by a nurse-midwife only in a medical emergency and only in accordance with client specific standing orders written by a physician.(B) Local anesthesia for the infiltration of the perineum for episiotomy repair may be administered in accordance with client specific standing orders written by the physician.(C) The following practices are prohibited:(1) use of any analgesics subject to regulation under M.G.L. c. 94C for pain control during labor;(2) inhibition, stimulation or augmentation of the first or second stage of labor with controlled substances;(3) use of general or regional anesthesia except as permitted in 105 CMR 142.650(B);(4) maintenance of controlled substances or provision of controlled substances for self-administration outside of the birth center.(D) Prescriptions shall be issued for all controlled substances required by clients outside of the birth center.Amended by Mass Register Issue 1272, eff. 10/24/2014.