SPS 182.03(4)(c)
(c) A licensed midwife shall consult with a licensed physician or licensed certified nurse-midwife with regard to any neonate who is born with or develops the following risk factors:
SPS 182.03(4)(c)1.
1. Apgar score of 6 or less at 5 minutes without significant improvement by 10 minutes.
SPS 182.03(4)(c)22.
22. Clinically significant abnormalities in vital signs, muscle tone or behavior.
SPS 182.03(4)(c)23.
23. Clinically significant color abnormality, cyanotic, or pale or abnormal perfusion.
SPS 182.03(5)(a)
(a) Transport via private vehicle is an acceptable method of transport if it is the most expedient and safest method for accessing medical services. The licensed midwife shall initiate immediate transport according to the licensed midwife's emergency plan; provide emergency stabilization until emergency medical services arrive or transfer is completed; accompany the client or follow the client to a hospital in a timely fashion; provide pertinent information to the receiving facility and complete an emergency transport record. The following conditions shall require immediate physician notification and emergency transfer to a hospital:
SPS 182.03(5)(a)7.
7. Shoulder dystocia not resolved by Advanced Life Support in Obstetrics (ALSO) protocol.
SPS 182.03(5)(a)12.
12. Clinically significant fetal heart rate patterns or other manifestation of fetal distress.
SPS 182.03(5)(a)19.
19. Failure to deliver placenta after one hour if there is no bleeding and fundus is firm.
SPS 182.03(5)(a)21.
21. Other conditions or symptoms that could threaten the life of the mother, fetus or neonate.
SPS 182.03(5)(b)
(b) A licensed midwife may deliver a client with any of the complications or conditions set forth in par.
(a), if no physician or other equivalent medical services are available and the situation presents immediate harm to the health and safety of the client; if the complication or condition entails extraordinary and unnecessary human suffering; or if delivery occurs during transport.
SPS 182.03(6)
(6) Prohibited practices. A licensed midwife may not do any of the following:
SPS 182.03(6)(a)
(a) Administer prescription pharmacological agents intended to induce or augment labor.
SPS 182.03(6)(b)
(b) Administer prescription pharmacological agents to provide pain management.
SPS 182.03(6)(e)
(e) Provide out-of-hospital care to a woman who has had a vertical incision cesarean section.
SPS 182.03(6)(f)
(f) Perform surgical procedures including, but not limited to, cesarean sections and circumcisions.
SPS 182.03(6)(g)
(g) Knowingly accept responsibility for prenatal or intrapartum care of a client with any of the following risk factors:
SPS 182.03(6)(g)1.
1. Chronic significant maternal cardiac, pulmonary, renal or hepatic disease.
SPS 182.03(6)(g)3.
3. Significant hematological disorders or coagulopathies, or pulmonary embolism.
SPS 182.03(6)(g)10.
10. Pelvic or uterine abnormalities affecting normal vaginal births, including tumors and malformations.
SPS 182.03(6)(g)15.
15. Social or familial conditions unsatisfactory for out-of-hospital maternity care services.
SPS 182.03(6)(g)16.
16. Fetus with suspected or diagnosed congenital abnormalities that may require immediate medical intervention.
SPS 182.03 History
History: CR 06-096: cr.
Register December 2006 No. 612, eff. 5-1-07; renumbers to (4) (b) 1. za., zb. and zc. made under s. 13.93 (2m) (b) 1., Stats.,
Register November 2007 No. 623.
