A certified direct-entry midwife may not

1. (1) administer prescription pharmacological agents intended to induce or augment labor;
2. (2) administer prescription pharmacological agents to provide pain management;
3. (3) use vacuum extractors or forceps;
4. (4) prescribe medications;
5. (5) provide out-of-hospital delivery services to a woman who has had a vertical incision cesarean section;
6. (6) perform surgical procedures, except episiotomy, including cesarean sections, abortions, and circumcisions; or

7. (7) knowingly accept responsibility for prenatal or intrapartum care of a client with any of the following diagnosed risk factors:

   1. (A) chronic and significant maternal cardiac, pulmonary, renal, or hepatic disease;
   2. (B) malignant disease in an active phase;
   3. (C) significant hematological disorders or coagulopathies, or pulmonary embolism;
   4. (D) insulin-requiring diabetes mellitus;
   5. (E) known maternal congenital abnormalities affecting childbirth;
   6. (F) confirmed isoimmunization, Rh disease with positive titer;
   7. (G) active tuberculosis;
   8. (H) active syphilis or gonorrhea;
   9. (I) active genital herpes infection two weeks prior to labor or in labor;
   10. (J) pelvic or uterine abnormalities affecting normal vaginal births, including tumors and malformations;
   11. (K) untreated alcoholism or alcohol abuse;
   12. (L) untreated drug addiction or substance abuse;
   13. (M) confirmed AIDS status;
   14. (N) uncontrolled current serious psychiatric illness; or
   15. (O) social or familial conditions unsatisfactory for out-of-hospital maternity care services.

(Eff. 5/11/94, Register 130; am 3/2/2011, Register 197; am 2/11/2017, Register 221; am 11/25/2018, Register 228; am 2/22/2023, Register 245)