Okla. Admin. Code § 310:395-5-6

Current through Vol. 42, No. 7, December 16, 2024
Section 310:395-5-6 - Conditions precluding Midwifery care
(a) The following conditions preclude Midwifery care and the Client must be transferred to a physician, CNM, or Clinician upon diagnosis:
(1) Severe asthma;
(2) Cyanotic heart disease or presence of a prosthetic valve;
(3) New York Heart Association class two heart failure;
(4) History of cardiac surgery with an abnormal echocardiogram;
(5) Pulmonary Hypertension;
(6) Hemoglobinopathies; sickle cell disease, thalassemia;
(7) Chronic hypertension on medication or with renal or heart disease;
(8) Severe obstructive pulmonary disease;
(9) Chronic renal disease with a creatinine of greater than 1.5;
(10) Lupus;
(11) Marfan syndrome;
(12) History of intracranial injury (stroke, AV malformation, or aneurisms);
(13) Prolonged anti-coagulation;
(14) Type 1 diabetes;
(15) Severe Polyhydramnios less than 34 weeks;
(16) Triplets or greater;
(17) Monoamniotic twins;
(18) Conjoined twins;
(19) Placenta accrete;
(20) Documented placenta previa in the third trimester; the placenta shall not be previa. To determine this, in the case of documented placenta previa or marginal placenta previa in the second trimester, a third trimester ultrasound must show resolution by 36 weeks or the Client must be referred. The Client must obtain an official ultrasound report with images performed by a Registered Diagnostic Medical Sonographer (RDMS) to determine that the location of the placenta is not previa or marginal placenta previa no later 34 weeks.
(21) Uncontrolled seizure disorder;
(22) Evidence of placenta abruption;
(23) Evidence of preeclampsia/eclampsia;
(24) Active tuberculosis or other serious pulmonary pathology;
(25) Inadequately treated syphilis;
(26) Hepatic disorders (cholestasis);
(27) Uncontrolled endocrine disorders;
(28) Significant hematological disorders;
(29) Active cancer;
(30) Active alcoholism or abuse;
(31) Active drug addiction or abuse; and
(32) Positive for HIV antibody.
(b) The following conditions preclude Midwifery care and the Client must be transferred to a physician, CNM, or Clinician upon diagnosis unless the Client obtains a signed consult note from a medically relevant physician and all recommended treatments can be completed in an out of hospital setting.
(1) History of seizure disorder;
(2) History of preterm labor or cervical insufficiency;
(3) Evidence of shortened cervix;
(4) Positive for Hepatitis B;
(5) History of chronic hypertension;
(6) Isoimmunization;
(7) History of post-partum hemorrhage with concurrent anemia;
(8) History of unexplained, recurrent stillbirths or neonatal death;
(9) Severe psychiatric illness within the last six (6) months as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM);
(10) Pregnancy that extends beyond 42 weeks 0/7 days gestational age;
(11) Two or more previous cesarean deliveries unless the Client has also had a successful vaginal delivery since the last cesarean delivery;
(12) BMI over 50 at onset of pregnancy;
(13) Type 2 diabetes; and
(14) History of cardiac surgery with a normal echocardiogram within the last 12 months.

Okla. Admin. Code § 310:395-5-6

Adopted by Oklahoma Register, Volume 38, Issue 06, December 1, 2020, eff. 11/2/2020
Adopted by Oklahoma Register, Volume 38, Issue 12, March 1, 2021, eff. 2/2/2021
Adopted by Oklahoma Register, Volume 38, Issue 24, September 1, 2021, eff. 9/11/2021