SPS 182.03(5)(a)10.10. Severe abdominal pain inconsistent with normal labor.
SPS 182.03(5)(a)11.11. Chorioamnionitis.
SPS 182.03(5)(a)12.12. Clinically significant fetal heart rate patterns or other manifestation of fetal distress.
SPS 182.03(5)(a)13.13. Presentation not compatible with spontaneous vaginal delivery.
SPS 182.03(5)(a)14.14. Laceration greater than second degree perineal or any cervical.
SPS 182.03(5)(a)15.15. Hemorrhage non-responsive to therapy.
SPS 182.03(5)(a)16.16. Uterine prolapse or inversion.
SPS 182.03(5)(a)17.17. Persistent uterine atony.
SPS 182.03(5)(a)18.18. Anaphylaxis.
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)20.20. Sustained instability or persistent abnormal vital signs.
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)(c)(c) Use vacuum extractors or forceps.
SPS 182.03(6)(d)(d) Prescribe medications.
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)2.2. Malignant disease in an active phase.
SPS 182.03(6)(g)3.3. Significant hematological disorders or coagulopathies, or pulmonary embolism.
SPS 182.03(6)(g)4.4. Insulin requiring diabetes mellitus.
SPS 182.03(6)(g)5.5. Known maternal congenital abnormalities affecting childbirth.
SPS 182.03(6)(g)6.6. Confirmed isoimmunization, Rh disease with positive titer.
SPS 182.03(6)(g)7.7. Active tuberculosis.
SPS 182.03(6)(g)8.8. Active syphilis or gonorrhea.