Mont. Admin. r. 24.111.603

Current through Register Vol. 23, December 6, 2024

Rule 24.111.603 - DIRECT-ENTRY MIDWIFE PROTOCOL STANDARD LIST REQUIRED FOR APPLICATION

(1) The antepartum protocol standards include, but are not limited to, the following:

(a) abruptio placenta (suspected);

(b) anemia;

(c) bleeding, first, second and third trimesters;

(d) breech presentation;

(e) candidiasis;

(f) care schedule;

(g) date/size discrepancy;

(h) ectopic pregnancy;

(i) fetal demise first, second, third trimester;

(j) genetic counsel;

(k) glycosuria/glucose screen;

(l) group beta strep;

(m) Hepatitis B;

(n) HIV;

(o) human papilloma virus (HPV);

(p) hyperemesis gravidarum;

(q) internal pelvic examination;

(r) intrauterine growth retardation;

(s) minor pregnancy discomfort (heartburn, constipation, insomnia, etc.);

(t) placenta previa (suspected);

(u) polyhydramnios;

(v) post dates pregnancy;

(w) pregnancy induced hypertension (mild, severe);

(x) proteinuria;

(y) Rh negative;

(z) sexually transmitted diseases (chlamydia, herpes, bacterial vaginosis, gonorrhea, trichomosis, etc.);

(aa) transfer of care/termination of midwife-parent relationship;

(ab) twins (diagnosis of);

(ac) ultrasound (indications for);

(ad) urinary tract infection;

(ae) vaginal birth after cesarean.

(2) The intrapartum protocol standards include, but are not limited to, the following:

(a) amnionitis/chorioamnionitis;

(b) bleeding in labor;

(c) care schedule;

(d) edematous cervical lip;

(e) emergency breech delivery;

(f) emergency twin delivery;

(g) face presentation;

(h) fetal distress;

(i) fetal heart rate evaluation;

(j) indications for transfer of care;

(k) meconium staining;

(l) nuchal cord;

(m) oxygen in labor;

(n) perineal support;

(o) placenta abruptio;

(p) posterior fetal presentation;

(q) premature labor;

(r) prolonged rupture of membranes;

(s) prolapsed cord;

(t) shoulder dystocia;

(u) stillbirth;

(v) vaginal birth after cesarean.

(3) The postpartum protocol standards include, but are not limited to, the following:

(a) assessment of placenta;

(b) breast care;

(c) care schedule;

(d) delivery of placenta;

(e) depression;

(f) hematoma;

(g) hemorrhage;

(h) hemorrhoids;

(i) perineal second degree laceration or episiotomy repair (suture);

(j) preparation of mother for transport;

(k) retained placenta (manual removal);

(l) Rh negative mom;

(m) shock;

(n) subinvolution;

(o) uterine infection;

(p) uterine inversion.

(4) The newborn protocol standards include, but are not limited to, the following:

(a) care schedule (postpartum visits);

(b) eye prophylaxis;

(c) hypoglycemia (suspected);

(d) hypothermia;

(e) infection (suspected sepsis);

(f) evaluation of jaundice;

(g) neonatal resuscitation;

(h) newborn examination to include gestational age determination and assessment of minor anomalies;

(i) newborn metabolic screening;

(j) newborn critical congenital heart disease screening using pulse oximetry;

(k) normal newborn transition to include maintenance of body temperature, cardiopulmonary function;

(l) normal infant feeding patterns;

(m) polycythemia (suspected);

(n) preparation of infant for transport;

(o) problems of large- and small-for-gestational-age infants;

(p) respiratory distress;

(q) umbilical cord care;

(r) vitamin K administration.

Mont. Admin. r. 24.111.603

NEW, 1999 MAR p. 2038, Eff. 9/24/99; TRANS, from Commerce, 2001 MAR p. 1642; AMD, 2001 MAR p. 1644, Eff. 8/24/01; AMD,2018 MAR p. 976, Eff.5/12/2018

AUTH: 37-1-131, 37-27-105, MCA; IMP: 37-1-131, 37-27-201, MCA