N.H. Admin. Code § Mid 503.04

Current through Register No. 45, November 7, 2024

Section Mid 503.04 - Midwife's Duty to Provide Potential Client with Information

Before obtaining a potential VBAC client's signature and the date of the signature on the informed consent form described in Mid 503.05 a midwife shall:

(a) Provide her with NNEPQIN's patient education brochure describing in-hospital VBAC and entitled "Birth Choices After Cesarean Section";

(b) Provide her with NNEPQIN's informed consent form, excluding the signature page, related to in-hospital VBAC and entitled "Consent for Birth After Cesarean Section";

(c) Provide her with a copy of Mid 503;

(d) Discuss with the potential client the following:

(1) That out-of-hospital VBAC involves labor and delivery at home or in a freestanding birth center with a midwife certified in this state in attendance in either case;

(2) As part of a review of Mid 503:

a. The midwife's obligation to comply with Mid 503;

b. The potential client's eligibility for out-of-hospital VBAC pursuant to Mid 503.02; and

c. How the midwife would carry out the duties set forth in Mid 503.03 if the potential client were to choose out-of-hospital VBAC;

(3) The normal risks of labor and of VBAC in any setting, including the risk of uterine rupture during labor;

(4) The risks associated with out-of-hospital VBAC which are additional to those associated with in-hospital VBAC;

(5) The precautions that the midwife would take if the potential client were to choose out-of-hospital VBAC, including but not limited to:

a. Use of obstetric ultrasound;

b. Close monitoring of mother and baby during active labor; and

c. Choosing a birth location no more than 20 minutes' drive from a hospital with obstetrical and anesthesia services on call 24 hours a day;

(6) The possible benefits of out-of-hospital VBAC over in-hospital VBAC whenever there is no need for transfer to a hospital, including:

a. No surgical intervention;

b. Greater freedom of movement and of positioning at time of birth; and

c. Birth in familiar and private surroundings with the support of the potential client's midwife;

(7) The possible benefits of in-hospital VBAC over out-of-hospital VBAC, including the availability in hospitals of resources not available in an out-of-hospital setting, including immediate access to surgical intervention and intensive care facilities and services; and

(8) The possibility that the potential client might need to be transferred to a hospital; and

(d) Answer the potential client's questions.

N.H. Admin. Code § Mid 503.04

#7931, eff 8-6-03

Amended by Volume XXXVI Number 49, Filed December 8, 2016, Proposed by #12040, Effective 11/10/2016, Expires 11/10/2026.