Okla. Admin. Code § 310:395-5-11

Current through Vol. 42, No. 3, October 15, 2024

Section 310:395-5-11 - Postpartum care

(a) Licensed Midwife responsibilities shall include, but are not limited to:

(1) The Licensed Midwife shall remain with the mother and infant for a minimum of two (2) hours postpartum, or until the mother's fundus is firm, lochia normal, mother has voided, mother and infant vitals are within Normal range and the Newborn has fed, whichever is longest;

(2) The Licensed Midwife shall conduct a thorough genital exam for laceration and make necessary repairs unless it is outside his or her training or skill level;

(3) In case of an unsensitized Rh negative mother, the Licensed Midwife shall obtain a sample of cord blood from the placenta and arrange for testing within twenty-four (24) hours of the birth and recommend the mother receive Rh immunoglobulin (Rhlg) as indicated within seventy-two (72) hours of delivery; and

(4) Recommended post-partum schedule:

(A) At least one (1) postpartum visit within twenty-four (24) to forty-eight (48) hours after the birth;

(B) A second visit at day five (5) or six (6) from birth;

(C) Provide a subsequent visit by two (2) and six (6) weeks postpartum to evaluate the condition of the mother and Newborn; and

(D) Major deviations from this schedule should be documented in the Client's file.

(b) The Licensed Midwife shall make an immediate Referral for any woman who during the Postpartum Period:

(1) Has signs and symptoms of postpartum Endometritis;

(2) Has signs and symptoms of postpartum pre-eclampsia;

(3) Has 3 rd or 4 th degree lacerations requiring medical attention; or

(4) Uterine atony or bleeding more than normal lochia flow;

(c) The Licensed Midwife shall obtain Medical Consultation for a woman who during the Postpartum Period:

(1) Has signs and symptoms of postpartum infection, which include but are not limited to:

(A) Mastitis; or

(B) Urinary tract infection.

(2) Has signs and symptoms of sub-involution;

(3) Has signs and symptoms of persistent postpartum depression by evaluation with a validated instrument to diagnose postpartum depression conducted as necessary and no later than the six (6) week visit;

(4) Abnormal vital signs;

(5) Foul-smelling lochia;

(6) No voiding within four (4) to six (6) hours of birth;

(7) Excessive pain or discomfort;

(8) Continuing urinary incontinence;

(9) Continuing fecal incontinence;

(10) Symptoms of hypovolemia; or

(11) The Client desires consultation.

Okla. Admin. Code § 310:395-5-11

Adopted by Oklahoma Register, Volume 38, Issue 06, December 1, 2020, eff. 11/2/2020

Adopted by Oklahoma Register, Volume 38, Issue 12, March 1, 2021, eff. 2/2/2021

Adopted by Oklahoma Register, Volume 38, Issue 24, September 1, 2021, eff. 9/11/2021