Section 12 AAC 14.500 - Practice(a) A certified direct-entry midwife shall (1) recommend, before care or delivery of a client, that the client undergo a physical examination performed by a physician, physician assistant, or advanced practice registered nurse who is licensed in this state; (2) obtain informed consent from a client before onset of labor; (3) at the first prenatal visit, or not later than 10 days after the first prenatal visit, order a serological test for syphilis; (4) provide each client with contact information for 24-hour on-call availability by a certified direct-entry midwife throughout the pregnancy, intrapartum period, and postpartum period; (5) provide each client with labor support, fetal monitoring, and routine assessment of vital signs once active labor is established; (6) supervise the delivery of infant and placenta, assess newborn and maternal well-being in the immediate postpartum period, and perform Apgar scores; (7) perform routine cord management and inspect for appropriate number of vessels; (8) inspect the placenta and membranes for completeness; (9) inspect the perineum and vagina postpartum for lacerations and stabilize or repair, as appropriate; (10) observe the mother and newborn postpartum until stable condition is achieved;(11) instruct the mother, father, or other support persons, both verbally and in writing, of the special care and precautions for both mother and newborn in the immediate postpartum period;(12) reevaluate maternal and newborn wellbeing not later than 36 hours after delivery; (13) use universal precautions with all biohazard materials; (14) ensure that a birth certificate is accurately completed and filed in accordance with state law; (15) ensure the newborn is tested for phenylketonuria (PKU); (16) offer to one or both parents to obtain and submit a blood sample in accordance with the recommendations for metabolic screening of the newborn; (17) offer an injection of vitamin K for the newborn in accordance with the indication, dose, and administration route set out in 12 AAC 14.570; (18) not later than one week after delivery, refer the parents to a facility with a newborn hearing screening program;(19) not later than two hours after the birth, offer to one or both parents the administration of antibiotic ointment into the eyes of the newborn, in accordance with state law on the prevention of infant blindness; (20) provide postpartum care and postpartum depression screenings and referrals to client through the first year postpartum; and (21) maintain adequate antenatal and perinatal records of each client and provide records to any consulting licensed physician and advanced practice registered nurse in accordance with regulations under P.L. 104-191 (Health Insurance Portability and Accountability Act of 1996(HIPAA). (b) During the third trimester, the certified direct-entry midwife shall ensure that the home-birth client is adequately prepared for a home-birth by discussing issues such as sanitation, facilities, adequate heat, availability of telephone and transportation, plans for emergency evacuation to a hospital, and the skills and equipment that the midwife will bring to the home-birth. (c) A certified direct-entry midwife shall make a home visit to the client before delivery to assess the physical environment, to determine whether the home-birth client has the necessary supplies, to prepare the client for the birth, and to instruct the family in correction of problems or deficiencies.Eff. 5/11/94, Register 130; am 5/2/2004, Register 170; am 10/18/2007, Register 184; am 3/2/2011, Register 197; am 8/10/2011, Register 199; am 9/9/2016, Register 219, October 2016; am 11/25/2018,Register 228, January 2019; am 2/22/2023, Register 245, April 2023 Authority:AS 08.65.030
AS 08.65.140
AS 08.65.190