Nev. Admin. Code § 449.Sec. 17.1

Current through November 8, 2024

Section 449.Sec. 17.1 - NEW

1. The director of a freestanding birthing center shall establish:

(a) Criteria for determining whether the risk of a pregnancy is too high for a person to give birth in the freestanding birthing center. Those criteria must align with the risk factors prescribed in the publication adopted by reference in section 12.

(b) Protocols for determining whether a pregnant person is progressing normally through active labor.

2. A freestanding birthing center may allow a pregnant person to give birth at the freestanding birthing center if:

(a) The pregnant person is eligible to give birth in the freestanding birthing center when evaluated using the criteria established pursuant to paragraph (a) of subsection 1;

(b) Except as otherwise provided in subsection 3, the pregnant person is not less than 15 years of age or greater than 40 years of age;

(c) The gestational age of the pregnancy is not less than 252 days and not greater than 294 days;

(d) There is no medical, obstetric, fetal or neonatal condition that would preclude a safe labor, birth and postpartum period at the freestanding birthing center, including, without limitation:

(1) No previous history of major surgery of the uterine wall or more than one previous cesarean birth; and

(2) No clinically significant signs or symptoms of:

(I) Chronic hypertension with or without medications;

(II) Polyhydramnios or oligohydramnios;

(III) Abruptio placenta;

(IV) Chorioamnionitis;

(V) Multiple gestation;

(VI) Retardation of intrauterine growth;

(VII) Meconium-stained amniotic fluid associated with signs of fetal intolerance of labor;

(VIII) Fetal intolerance of labor;

(IX) Active substance use disorder;

(X) Placenta previa;

(XI) Medication dependent diabetes; or

(XII) Anemia that is not resolved with treatment;

(e) During active labor, the pregnant person does not demonstrate clinically significant signs or symptoms of:

(1) Intrapartum hemorrhage;

(2) Active herpes simplex II of the genitals; or

(3) Malpresentation of the fetus, including, without limitation, breech presentation;

(f) The pregnant person is progressing normally through active labor, as determined by the clinical providers of the freestanding birthing center in accordance with the protocols established pursuant to paragraph (b) of subsection 1;

(g) The membranes of the pregnant person did not rupture more than 48 hours before the admission of the pregnant person to the freestanding birthing center;

(h) The pregnant person shows no evidence of a significant infection for which treatment is beyond the scope of practice of the clinical provider who will be responsible for the care of the pregnant person; and

(i) The pregnancy is appropriate for a setting where anesthesia is limited to a local infiltration of the perineum, a pudendal block or the use of nitrous oxide for pain relief during labor.

3. The director of a freestanding birthing center may allow a pregnant person who does not meet the requirements of paragraph (b) of subsection 2 to give birth at the freestanding birthing center if, after reviewing the specific case of the pregnant person, the director determines that it is safe for the pregnant person to give birth at the freestanding birthing center.

Nev. Admin. Code § 449.Sec. 17.1

Added to NAC by Bd. of Health by R062-21A, eff. 9/8/2022

NRS 439.200, 449.0302, as amended by section 16.5 of Assembly Bill No. 287, chapter 517, Statutes of Nevada 2021, at page 3437