Okla. Admin. Code § 310:395-5-6

Current through Vol. 42, No. 4, November 1, 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