Section Mid 502.06 - Consultation to Determine Setting for Care During the Immediate Postpartum 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 or the newborn should be transferred to the hospital setting if any of the following conditions should occur immediately postpartum:
(a) Significantly bleeding cervical lacerations;(b) Third or fourth degree perineal lacerations;(c) Uncontrolled maternal bleeding when the condition of the woman is becoming unstable;(d) Maternal fever or unstable vital signs;(e) An Apgar score of 6 or less at 5 minutes after birth, or an Apgar score that is dropping;(f) Jaundice in the newborn appearing before 24 hours after birth;(g) Obvious congenital anomalies;(h) A newborn who is SGA;(i) A newborn who shows signs of hypoglycemia, such as jitteriness, lethargy, or hypothermia;(j) A newborn with persistent central cyanosis or pallor;(k) A newborn with persistent signs of respiratory difficulty without signs of improvement within one hour after birth;(l) A newborn with a pulse rate greater than 160 at rest persisting for longer than 2 hours;(m) A newborn with respirations greater than 80 at rest persisting for longer than 2 hours;(n) A newborn with temperature outside the parameters of 97.7-99.4 degrees Fahrenheit or 36.5 to 37.5 degrees Celsius persisting for longer than 2 hours; or(o) Other conditions which the midwife assesses as outside normal limits.N.H. Admin. Code § Mid 502.06
Amended by Volume XXXVI Number 49, Filed December 8, 2016, Proposed by #12040, Effective 11/10/2016, Expires 11/10/2026.