Section Mid 502.05 - Consultation With Physician or CNMto Determine Setting for Care During the Intrapartum PeriodA midwife shall consult immediately with a physician with experience in the active practice of obstetrics or with a CNM about whether the care of the client should be transferred to the hospital setting if any of the following conditions should occur intrapartum:
(a) Unforeseen malpresentations;(b) Unforeseen multiple fetuses;(c) Fetal distress as indicated by heart rate monitoring;(d) The presence of particulate meconium;(e) Failure to progress such that:(1) In the first stage of labor, there is a lack of progress in dilation and descent for a period of up to 24 hours in the case of a primigravida or 18 hours in the case of a multigravida;(2) In the second stage, there are more than 2 hours without progress in descent or more than 3 hours with slow descent; or(3) In the third stage, there is more than one hour without delivery of the placenta;(f) More than 18 hours elapse following the rupture of the membranes without the onset of labor;(g) Maternal distress including:(1) Extreme physical or mental exhaustion;(2) Abnormal vital signs; and(3) Uncontrolled maternal bleeding.N.H. Admin. Code § Mid 502.05
Amended by Volume XXXVI Number 49, Filed December 8, 2016, Proposed by #12040, Effective 11/10/2016, Expires 11/10/2026.