4 Colo. Code Regs. § 739-1.7
Current through Register Vol. 47, No. 22, November 25, 2024
Section 4 CCR 739-1.7 - MINIMUM PRACTICE REQUIREMENTS REGARDING POSTPARTUM CAREThe purpose of this Rule is to define and clarify minimum practice requirements of safe care for women and infants regarding postpartum care pursuant to sections 12-225-106 and 12-225-107, C.R.S., which include but are not limited to:
A. The direct-entry midwife who is authorized to administer medications may administer Oxytocin (Pitocin) in accordance with Rule 1.17.B. The direct-entry midwife shall remain with the client and infant for a minimum of two hours after the birth or until the client and infant are stable, whichever is longer.C. At a minimum, the direct-entry midwife shall make follow up visits to assess the progress of the client and infant within 24 to 48 hours postpartum, 3 to 7 days postpartum, 2-4 weeks postpartum and 6 weeks postpartum. If the client is seen by an appropriate health care provider at any of these intervals, the direct-entry midwife need not visit the client for that particular interval. Such visits shall include, but not be limited to, an assessment of the fundus, lochia, perineum, breasts, nutrition, hydration, elimination, emotional adjustment and bonding.D. The direct-entry midwife shall instruct the client and family in self-care at each follow up visit.E. The direct-entry midwife who is authorized to administer medications may administer Rh(D) Immune Globulin to Rh negative mothers in accordance with Rule 1.17. Otherwise, the direct-entry midwife shall refer all Rh negative mothers for Rhogam within seventy two hours of the birth if the baby is RH positive.F. The direct-entry midwife shall arrange for consultation and/or transport when: 1. There is maternal blood loss of more than 500 cc unless bleeding is controlled and all maternal vital signs are stable;2. The client has a fever of greater than 101°F on any of the 2nd through 10th days postpartum;3. The client cannot void within 6 hours after birth;4. The lochia is excessive, foul smelling, or otherwise abnormal;5. The client exhibits signs of clinically significant depression (not the "baby blues");6. There are vaginal or cervical lacerations requiring repair (unless otherwise addressed in Rule 1.20); or7. Persistent blood pressure greater than 140/90.40 CR 12, June 25, 2017, effective 8/1/201741 CR 01, January 10, 2018, effective 1/30/201843 CR 03, February 10, 2020, effective 1/1/202043 CR 07, April 10, 2020, effective 4/30/202043 CR 22, November 25, 2020, effective 12/15/202044 CR 09, May 10, 2021, effective 5/30/202144 CR 20, October 25, 2021, effective 11/14/202145 CR 17, September 10, 2022, effective 8/15/202245 CR 21, November 10, 2022, effective 11/30/2022