Ariz. Admin. Code § R9-16-114 - Midwife Report after Termination of Midwifery Services

A. A midwife shall complete a midwife report for each client, in a format provided by the Department, that includes the following:

1. The midwife's:

a. First name,

b. Last name, and

c. License number;

2. The client's:

a. Date of birth;

b. Client number;

c. Date of last menstrual period;

d. Estimated date of delivery;

e. Gravida, the number of times the client has been pregnant, including a current pregnancy, regardless of whether these pregnancies were carried to term;

f. Para, the number of times the client has given birth at greater than 20 weeks of gestation, including viable and non-viable births, where multiples are counted as one birth; and

g. If applicable, whether the client had a vaginal delivery after prior Cesarean section or vaginal delivery of a fetus in a complete breech or frank breech presentation;

3. A description of the maternal outcome, including any complications;

4. If a vaginal delivery after prior Cesarean section or vaginal delivery of a fetus in a complete breech or frank breech presentation:

a. Rate of dilation, and

b. Duration of second stage labor;

5. If applicable, the newborn's:

a. Date of birth;

b. Gender;

c. Weight;

d. Length;

e. Head circumference;

f. Designation of average, small, or large for gestational age;

g. Apgar score at one minute;

h. Apgar score at five minutes;

i. Existence of complications;

j. Description of complications, if applicable;

k. Birth certificate filing date; and

l. Birth certificate number, if available;

6. Whether the client required transfer of care and, if applicable:

a. Method of transport,

b. Type of facility or individual to which the midwife transferred care of the client,

c. Name of destination,

d. Time arrived at destination,

e. Confirmation the emergency care plan was utilized, and

f. Medical reason for transfer of care;

7. The date midwifery services were terminated;

8. Reason for the termination of midwifery services;

9. If termination of midwifery services was due to a medical condition, the specific medical condition;

10. Whether information was provided on newborn screening; and

11. Whether newborn screening tests were ordered as required in A.R.S. § 36-694.

B. The midwife shall submit a midwife report for a client to the Department within 30 calendar days after the termination of midwifery services to the client.

Notes

Ariz. Admin. Code § R9-16-114

Section made by exempt rulemaking at 19 A.A.R. 1805, effective July 1, 2013 (Supp. 13-2). Amended by final expedited rulemaking at 28 A.A.R. 1119, effective 5/4/2022.