Md. Code Regs. 10.64.01.04

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.64.01.04 - Required Consultation

A. A licensed direct-entry midwife shall consult with a health care practitioner and document:

(1) The consultation;

(2) The recommendations of the consultation; and

(3) The discussion of the consultation with the client if any of the following conditions are present during prenatal care:

(a) Significant mental disease, including depression, bipolar disorder, schizophrenia, and other conditions that impair the ability of the patient to participate effectively in the patient's care or that require the use of psychotropic drugs to control the condition;

(b) Second or third trimester bleeding;

(c) Intermittent use of alcohol into the second trimester;

(d) Asthma;

(e) Diet-controlled gestational diabetes;

(f) History of genetic problems, intrauterine death after 20 weeks' gestation, or stillbirth;

(g) Abnormal Pap smear;

(h) Possible ectopic pregnancy;

(i) Tuberculosis;

(j) Controlled hypothyroidism, being treated with thyroid replacement and euthyroid, and with thyroid test numbers in the normal range;

(k) Rh sensitization with positive antibody titer;

(I) Breech presentation between 35 and 38 weeks;

(m) Transverse lie or other abnormal presentation between 35 and 38 weeks;

(n) Premature rupture of membranes at 37 weeks or less;

(o) Small for gestational age or large for gestational age fetus;

(p) Polyhydramnios or oligohydramnios;

(q) Previous LEEP procedure or cone biopsy;

(r) Previous obstetrical problems, including uterine abnormalities, placental abruption, placenta accreta, obstetric hemorrhage, incompetent cervix, or preterm delivery for any reason;

(s) Post-term maturity (41 0/7 to 6/7 weeks gestational age);

(t) Inflammatory bowel disease, in remission; or

(u) Primary herpes simplex virus, infection or any active infection at time of delivery.

B. Any changes in the plan of care following a consultation in accordance with §A of this regulation shall be documented in the patient's plan of care.

Md. Code Regs. 10.64.01.04

Regulations .04 adopted effective 43:25 Md. R. 1384, eff. 12/19/2016