La. Admin. Code tit. 48 § I-6751

Current through Register Vol. 50, No. 9, September 20, 2024

Section I-6751 - Required Physician Consultation, Postpartum Period

A. The licensed healthcare practitioner shall obtain medical consultation or refer for emergent medical care any woman who, during the postpartum period:

1. has a third-degree or fourth-degree perineal laceration;

2. has uterine atony;

3. bleeds in an amount greater than 500 milliliters and still continuing to bleed;

4. does not urinate or empty her genitourinary bladder within two hours of birth;

5. develops a fever greater than 100.4 degrees Fahrenheit or 38 degrees Centigrade on any two of the first 10 days postpartum, excluding the first 24 hours;

6. develops foul smelling lochia; or

7. develops blood pressure below 100/50 if pulse exceeds 100, pallor, cold clammy skin, and/or weak pulse.

B. The licensed healthcare practitioner shall obtain medical consultation or refer for emergent medical care any infant who:

1. has an Apgar score of seven or less at five minutes;

2. has any obvious anomaly;

3. develops grunting respirations, retractions, or cyanosis;

4. has cardiac irregularities;

5. has a pale, cyanotic, or grey color;

6. develops jaundice within 48 hours of birth;

7. has an abnormal cry;

8. weighs less than 5 pounds or weighs more than 10 pounds;

9. shows signs of prematurity, dysmaturity, or post maturity;

10. has meconium staining of the placenta, cord, and/or infant with signs or symptoms of aspiration pneumonia;

11. does not urinate or pass meconium in the first 24 hours after birth;

12. is lethargic or does not feed well;

13. has edema;

14. appears weak or flaccid, has abnormal feces, or appears not to be normal in any other respect;

15. has persistent temperature below 97 degrees Fahrenheit per FSBC policy;

16. has jitteriness not resolved after feeding; or

17. has a blood glucose level of less than 45mg/dL.

C. The FSBC shall develop, implement, and enforce written policies to provide follow-up postpartum care to the newborn and the mother either directly or by referral. Follow up care may be provided in the FSBC, at the mother's residence, by telephone, or by a combination of these methods in accordance with accepted standards of practice.

La. Admin. Code tit. 48, § I-6751

Promulgated by the Department of Health and Human Resources, Office of the Secretary, Division of Licensing and Certification, LR 13:246 (April 1987), Promulgated by the Department of Health, Bureau of Health Services Financing, LR 482118 (8/1/2022), Amended LR 49483 (3/1/2023).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and R.S. 40:2180.21-2180.28.