4 Colo. Code Regs. § 739-1.4

Current through Register Vol. 47, No. 22, November 25, 2024

Section 4 CCR 739-1.4 - PRACTICE RESTRICTIONS

The purpose of this Rule is to define and clarify the practice restrictions applicable to a direct-entry midwife pursuant to sections 12-225-106 and 12-225-108(1)(a), C.R.S.

A. The direct-entry midwife shall not provide care to any client who has a medical history of or who exhibits signs or symptoms including but not limited to:

1. Previous diagnosis of diabetes mellitus or a diagnosis of gestational diabetes in the current pregnancy;

2. Hypertensive disease (blood pressure greater than 140/90 at rest);

3. Pulmonary disease or cardiac disease which interferes with activities of daily living;

4. Thrombophlebitis or pulmonary embolism;

5. Hematological or coagulation disorders, i.e., leukemia or sickle cell anemia;

6. Seizures controlled by medication if the client has seized within the last year;

7. Hepatitis B, HIV positive, or AIDS;

8. Current use of psychotropic medications if client is not under the care and monitoring of a physician during the pregnancy;

9. Current substance abuse of drugs or alcohol;

10. Rh sensitization (or any positive antibody titre);

11. Vaginal Birth after Cesarean Section (VBAC) unless compliant with Rule 1.12;

12. Delivery of an infant who was premature or stillborn, or a neonatal death associated with maternal health conditions, i.e., hypertension, Diabetes Mellitus, Rh Sensitization, clotting disorders;

13. Incompetent cervix;

14. Previous uncontrolled postpartum hemorrhage; or

15. Delivery of an infant with a major genetic anomaly as reviewed by a pediatrician, perinatologist, or genetic counselor regarding the likelihood of recurrence unless the mother declines the consultation.

B. The direct-entry midwife shall not:

1. Perform any operative or surgical procedures;

2. Utilize forceps, vacuum extraction or other instruments or mechanical means to facilitate birth;

3. Perform versions; or

4. Administer any medications or IV fluids, except as permitted in section 12-225-107, C.R.S., and in Rules 1.17 and 1.18.

4 CCR 739-1.4

40 CR 12, June 25, 2017, effective 8/1/2017

41 CR 01, January 10, 2018, effective 1/30/2018

43 CR 03, February 10, 2020, effective 1/1/2020

43 CR 07, April 10, 2020, effective 4/30/2020

43 CR 22, November 25, 2020, effective 12/15/2020

44 CR 09, May 10, 2021, effective 5/30/2021

44 CR 20, October 25, 2021, effective 11/14/2021

45 CR 17, September 10, 2022, effective 8/15/2022

45 CR 21, November 10, 2022, effective 11/30/2022