(a) Personnel policies. - (1) There shall be on file in the birthing center written personnel policies and operating practices which define the services of the birthing center.
- (a) There shall be written job descriptions for each position in the birthing center including at least the title, authority, specific responsibilities and minimum qualifications. Each employee shall be provided a copy of his or her job description.
- (2) All staff shall be informed of and have access to the written policies.
- (3) Personnel records shall be maintained for each person employed in the birthing center which include at least:
- (a) An employment application;
- (b) verification of references and/or credentials as required;
- (c) incident and/or accident reports;
- (d) results of medical examinations required as a part of employment.
(b) Birthing Center Policies and Procedures. These shall include, but not be limited to: - (1) Definition of a low-risk pregnant patient who shall be eligible for birth services offered by the birth center.
- (2) Definition of a high risk patient who shall be ineligible for birth services at the birth center. (See Appendix 1)
- (3) Written policies for consultation, backup services, transfer and transport of a newborn and/or mother to a hospital where appropriate care is available.
- (4) Written policy and procedure with the ambulance service for emergency transport of a newborn and/or mother.
- (5) Written informed consent which shall be obtained prior to the onset of labor and shall include evidence of an explanation by personnel of the birth services offered and potential risks.
- (6) Provision for orientation and education of patients, family, and support persons in childbirth and newborn care. The birth center shall include a program of education which prepares women and their families for self-care and self-help, for psychoprophy laxis of pain, and which outlines the importance of good nutrition and prenatal care in pregnancy outcome. In addition, the adverse effects of smoking, alcohol, drugs, and poor nutrition shall be explained. Plans for medical evaluation, feeding, and care of the newborn shall be made.
- (7) Postpartum care. Mothers and infants shall be discharged within 24 hours after birth in accordance with standards set by the clinical staff and specified in the policy and procedures manual. A program for prompt follow-up care and postpartum evaluation after discharge shall be ensured and outlined in the manual of policies and procedures. This program shall include assessment of infant health including physical examination, laboratory screening tests at the appropriate times, maternal postpartum status, instruction in child care including immunization, referral to sources of pediatric care, provision of family planning services, and assessment of mother-child relationship including breast feeding.
- (8) Registration of birth and reporting of complications and anomalies.
- (9) Policy on fetal deaths.
(c) Infection Control. This shall include development and implementation of specific patient care and administrative policies aimed at investigating, controlling and prevention infections in the birthing center. Procedures shall be enforced to prevent the exposure of the woman and/or newborn to siblings, visitors and staff personnel with communicable disease.
(d) Arrangements shall be made for all mothers to be screened for blood -type and Rh Factor. Those determined to be Rh negative shall have provision for appropriate follow-up studies both prenatally and at time of delivery in order to determine the need for anti D Immune Globulin (Human) to prevent sensitization by the postpartum mother. There shall be evidence of a plan for the appropriate use of Rh immune globulin.
(e) Patients shall remain at the birthing center not less than six (6) hours not more than twenty--four (24) hours following delivery.