036-7 Wyo. Code R. §§ 7-1 - Scope and Practice Standards

A licensed midwife shall adhere to the following scope and practice standards when providing antepartum, intrapartum, postpartum, and newborn care.

(a) The Board hereby incorporates by reference the following uniform rules outlining the scope and practice standards:

(i) Philosophy and Principles of Practice and Scope of Practice, adopted by the NACPM revised 2004, found at: http://nacpm.org/about-cpms/professional-standards/

(ii) For these rules incorporated by reference:

(A) The Board has determined that incorporation of the full text in these rules would be cumbersome or inefficient given the length or nature of the rules;

(B) The incorporation by reference does not include any later amendments or editions of the incorporated matter beyond the applicable date identified in subsection (a) of this section; and

(C) The incorporated rule is maintained at Board Office and is available for public inspection and copying at cost at the same location.

(b) Conditions for Which a Licensed Midwife May Not Provide Care. A licensed midwife shall not provide care to a client with any of the disorders, diagnoses, conditions or symptoms listed in Wyoming Statute 33-46-103(j)(i)(A).

(c) Conditions for Which a Licensed Midwife May Not Provide Care Without Physician Involvement. Before providing care to a client with any of the disorders, diagnoses, conditions or symptoms listed in W.S. 33-46-103(j)(i)(B), the licensed midwife shall notify the client in writing that the client shall obtain the described physician care as a condition to the client's eligibility to obtain maternity care from the licensed midwife. The licensed midwife shall, additionally, obtain the client's signed acknowledgement that the client has received the written notice. A licensed midwife must also follow the requirements in this section if the client has any of the following:

(i) HIV positive; or

(ii) Anemic with documented hemoglobin at less than ten (10) at thirty seven (37) weeks.

(d) Follow the Conditions for Which a Licensed Midwife Shall Recommend Physician Involvement as referenced in the Act. Before providing care for a client with a history of any of the disorders, diagnoses, conditions or symptoms listed in W.S. 33-46-103(j)(i)(C), a licensed midwife shall provide written notice to the client that the client is advised to see a licensed physician during the client's pregnancy. Additionally, the licensed midwife shall obtain the client's signed acknowledgement that the client has received the written notice.

(e) Conditions for Which a Licensed Midwife Shall Facilitate Hospital Transfer as referenced in the Act. A licensed midwife shall facilitate the immediate transfer of a client to a hospital for emergency care if the client has any of the following disorders, diagnoses, conditions or symptoms listed in W. S. 33-46-103(j)(i)(D) or any of the following:

(i) Maternal fever in labor of more than 100.4 degrees Fahrenheit, in the absence of environmental factors;

(ii) Suggestion of fetal jeopardy, such as any abnormal bleeding (with or without abdominal pain), evidence of placental abruption, thick meconium, or abnormal fetal heart tones with non-reassuring patterns where birth is not imminent;

(iii) Noncephalic presentation at the onset of labor or rupture of membranes, whichever occurs first, unless birth is imminent or;

(iv) Rupture of membranes:

(A) longer than eighteen (18) hours without a documented negative Group B Streptococcus (GBS) screen and without intravenous (IV) antibiotic treatment;

(B) longer than twenty-four (24) hours without a documented negative GBS screen and with IV antibiotic treatment from the onset of labor or rupture of membranes, whichever occurs first;

(C) longer than twenty-four (24) hours with a documented negative GBS screen and without IV antibiotic treatment; or

(D) longer than thirty-six (36) hours with a documented negative GBS screen and IV antibiotic treatment.

(f) Plan for Emergency Transfer and Transport. When facilitating a transfer, the licensee shall notify the hospital when the transfer is initiated, accompany the client to the hospital if feasible, or communicate by telephone with the hospital if the licensed midwife is unable to be present. The licensed midwife shall also ensure that the transfer of care is accompanied by the client's medical record, which include:

(i) The client's name, address, and next of kin contact information;

(ii) A list of diagnosed medical conditions;

(iii) A list of prescription or over the counter medications regularly taken;

(iv) A history of previous allergic reactions to medications; and

(v) If feasible, the licensed midwife's assessment of the client's current medical condition and description of the care provided by the licensed midwife before transfer.

Notes

036-7 Wyo. Code R. §§ 7-1

Amended, Eff. 12/10/2015. Amended, Eff. 7/18/2018. Amended, Eff. 7/9/2019. Amended, Eff. 10/26/2021.