Section Mid 503.02 - Eligibility for Midwifery CareA midwife shall accept as a client a woman who has had a previous birth by cesarean section only if:
(a) The potential client has had only one previous cesarean section;(b) The midwife can confirm through a review of the records of the previous delivery by cesarean section that the section was performed through a low transverse uterine segment incision;(c) The potential client has had no other uterine surgeries;(d) At least 18 months' time separates the date of the potential client's previous cesarean section and the due date of the current pregnancy;(e) An obstetric ultrasound documents that the placenta is not in a low-lying anterior position;(f) The potential client plans to give birth in a location no more than 20 minutes' drive from a hospital with obstetrical and anesthesia services on call 24 hours a day;(g) The midwife: (1) Arranges a consultation between the client and an obstetrician affiliated with the hospital closest to the planned location of the birth to discuss the following topics: a. The information in NNEPQIN's patient education brochure entitled "Birth Choices After Cesarean Section"; andb. The hospital's abilities to respond if an emergency transfer from the care of the midwife to the hospital should become necessary; or(2) Having been refused a consultation for the potential client by every obstetrician affiliated with the hospital closest to the planned location of the birth, records that fact in the potential client's record;(h) The midwife provides the potential client with the information required by Mid 503.04; and(i) The midwife obtains the potential client's signature and date of signing on the informed consent form specified in Mid 503.05.N.H. Admin. Code § Mid 503.02
Amended by Volume XXXVI Number 49, Filed December 8, 2016, Proposed by #12040, Effective 11/10/2016, Expires 11/10/2026.