Chapter N 4

N 4.05(7)(c) (c) Provision of fraudulent information on an application for licensure.

N 4.05(7)(d) (d) Misrepresentation of being a nurse-midwife or a graduate nurse-midwife when applying for a temporary permit under this section.

N 4.05 History History: Cr. Register, September, 1985, No. 357, eff. 10-1-85; r. and recr. (5) (a), am. (1) to (3) and (6), Register, May, 1990, No. 413, eff. 6-1-90; CR 03-009: am. (5) (b) Register November 2003 No. 575, eff. 12-1-2003; CR 20-065: renum. (1) to (1) (intro.) and am., cr. (1) (a) to (c), am. (2), (3), renum. (4) to N 4.025 (3) and am., r. and recr. (5), r. (6), cr. (6m), am. (7) (intro.), (a), (b), cr. (7) (d) Register January 2022 No. 793, eff. 2-1-22.

N 4.06 N 4.06 Scope of practice.

N 4.06(1) (1) The scope of practice of nurse-midwifery is the overall management of women’s health care, pregnancy, childbirth, postpartum care for newborns, family planning, and gynecological services consistent with the standards of practice of the American College of Nurse-Midwives and the education, training, and experience of the nurse-midwife.

N 4.06(2) (2) A nurse-midwife shall collaborate with a physician with postgraduate training in obstetrics pursuant to a written agreement with that physician.

N 4.06(3) (3) A nurse-midwife shall consult with the collaborating physician regarding any complications discovered by the nurse-midwife or refer the patient pursuant to the written agreement under sub. (2).

N 4.06(4) (4) Upon referral under sub. (3), a nurse-midwife may independently manage that part of the care for a patient that is consistent with the education, training, and experience of the nurse-midwife.

N 4.06 History History: Cr. Register, December, 1981, No. 312, eff. 1-1-82; renum. from N 6.05, Register, September, 1985, No. 357, eff. 10-1-85; CR 03-009: am. Register November 2003 No. 575, eff. 12-1-2003; CR 20-065: am. Register January 2022 No. 793, eff. 2-1-22.

N 4.07 N 4.07 Limitations on the scope of practice.

N 4.07(1) (1) A nurse-midwife may not independently manage complications that require referral pursuant to the written agreement under s. N 4.06 (2).

N 4.07(2) (2) A nurse-midwife may not perform deliveries by forceps or Caesarean section.

N 4.07(2m) (2m) A nurse-midwife may use vacuum extractors only in emergency delivery situations.

N 4.07(3) (3) A nurse-midwife may not assume any responsibilities that are inconsistent with the education, training, and experience of the nurse-midwife.

N 4.07(4) (4) Following notification of a physician as required by s. 441.15 (4), Stats., a nurse-midwife may continue to manage a delivery if emergency measures are required and the physician has not yet arrived.

N 4.07 History History: Cr. Register, December, 1981, No. 312, eff. 1-1-82; renum. from N 6.06, Register, September, 1985, No. 357, eff. 10-1-85; CR 03-009: am. (1) and (2) Register November 2003 No. 575, eff. 12-1-2003; CR 20-065: am. (1), (2), cr. (2m), am. (3), (4) Register January 2022 No. 793, eff. 2-1-22.

N 4.09 N 4.09 Health care facilities where practice shall occur. A health care facility where the practice of nurse-midwifery may occur is one that has adequate equipment and personnel for conducting and monitoring the normal scope of practice and that has available methods for referral to or communication with a higher level care facility if the need arises.

N 4.09(2) (2) Deliveries may be arranged for only in a facility which has adequate sanitation, thermal regulation, staffing, communication systems and medical back-up.

N 4.09(3) (3) The above limitations do not apply to care given in emergency circumstances.

N 4.09 History History: Cr. Register, December, 1981, No. 312, eff. 1-1-82; renum. from N 6.08, Register, September, 1985, No. 357, eff. 10-1-85.

N 4.10 N 4.10 Malpractice insurance coverage.

N 4.10(1) (1) A nurse-midwife shall have in effect malpractice insurance evidenced by one of the following:

N 4.10(1)(a) (a) Personal liability coverage in the amounts specified in s. 655.23 (4), Stats.

N 4.10(1)(b) (b) Coverage under a group liability policy providing individual coverage for the nurse-midwife in the amounts set forth in s. 655.23 (4), Stats.

N 4.10(2) (2) Notwithstanding sub. (1), malpractice insurance is not required for any of the following:

N 4.10(2)(a) (a) A nurse-midwife who practices nurse-midwifery within the scope of employment as a federal, state, county, city, village, or town employee.

N 4.10(2)(b) (b) A nurse-midwife who practices nurse-midwifery as an employee of the federal public health service under 42 USC 233 (g).

N 4.10(2)(c) (c) A nurse-midwife who does not provide care for patients.

N 4.10(2)(d) (d) A nurse-midwife whose employer has in effect malpractice liability insurance that provides coverage for the nurse-midwife in an amount equal to or greater than the amounts specified in sub. (1) (a) or (b).

N 4.10(2)(e) (e) A nurse-midwife providing nurse-midwifery services under s. 257.03, Stats.

N 4.10 History History: Emerg. cr. eff. 11-05-02; CR 03-009: cr., Register November 2003 No. 575, eff. 12-1-2003; CR 20-065: am. (1) (intro.), (2) (a), (b), cr. (2) (d), (e), r. (3) Register January 2022 No. 793, eff. 2-1-22.