1. (a) In addition to meeting the requirements of 7 AAC 12.660, a birth center shall ensure that sufficient, qualified clinical staff and support staff are on duty and on call for the routine delivery of services needed by clients and newborns, and for the safe maintenance and operation of the birth center. The birth center shall assure client and newborn safety, including during any period of high demand or emergency, and shall assure that each client who is in active labor is attended as required under (e) of this section. The birth center shall

   1. (1) post a schedule listing available clinical staff and consulting specialists who may be contacted if necessary;

   2. (2) ensure that written personnel policies are available to personnel; these policies must include at least the following:

      1. (A) conditions of employment;
      2. (B) the respective obligations of employer and employee;
      3. (C) grievance procedures;

   3. (3) provide for training, education, and development of the clinical staff and support staff, including at least the following:

      1. (A) orientation of new staff members, including policies and procedures, infection control, fire safety, and the proper use of equipment used to care for clients and newborns in the birth center;
      2. (B) a reference library of current, relevant materials;
      3. (C) an in-service education program to maintain currency in relevant knowledge and skills, including skills that are used infrequently in birth center practice;
      4. (D) participation in continuing professional education programs, or information to assist the staff in participating in professional education programs provided elsewhere;
      5. (E) involvement in activities of professional organizations;
      6. (F) the annual training required under 7 AAC 12.860(4);
      7. (G) the training required under 7 AAC 12.416(b).

2. (b) The birth center shall ensure that an experienced, competent practitioner in obstetrics and gynecology is immediately available to the birth center by radio, telephone, or another means of direct communication for consultation or transfer of care. The practitioner must be a physician certified by the American Board of Obstetrics and Gynecology, a physician who is otherwise qualified through training and experience in obstetrics and gynecology, or a certified nurse midwife. The birth center shall develop and follow a written plan for consultation or transfer of care that includes

   1. (1) a plan for the delivery of care in a life-threatening situation; and
   2. (2) detailed instructions for the staff if no practitioner can be reached for consultation or transfer of care.

3. (c) If the practitioner providing services in a birth center is a

   1. (1) certified nurse midwife, the birth center must maintain a record of the written plan required under 12 AAC 44.400(a)(5) and include that plan in the written plan for consultation required under (b) of this section; or
   2. (2) direct-entry midwife, the birth center must maintain a record of the written medical back-up arrangements required in 12 AAC 14.550(a) and include it in the plan for consultation required under (b) of this section.
4. (d) Midwifery services must include antepartum, intrapartum, and postpartum care.

5. (e) For each client who is admitted for delivery, a physician or a midwife who is certified in CPR and NRP as required under 7 AAC 12.405(b)(4)(B) must be present from the time of admission through all stages of labor and delivery. A second person, who is an employee, a member of the clinical staff, or a student midwife, and who is certified in CPR and NRP as required under 7 AAC 12.405(b)(4)(B), must be

   1. (1) immediately available to the birth center during the latent phase of the first stage of labor;
   2. (2) present in the birth center during the active phase of the first stage of labor, if determined necessary by the midwife; and
   3. (3) present during delivery and for at least the first hour of the postpartum phase.

(Eff. 5/14/82, Register 82; am 11/19/83, Register 88; am 9/30/2007, Register 183)

Authority: AS 47.32.010, AS 47.32.030