- (1) No surgical procedures shall be performed in the birthing center except episiotomy, repair of episiotomy or laceration, or circumcision. Surgical repairs of fourth degree lacerations may only be performed in a birthing center by the staff physician or consultant physician. Circumcisions of male infants may be performed in a birthing center by the staff physician or consultant physician or by a CNM who has been approved to perform circumcision of male infants through a collaborative practice agreement approved by the Alabama State Board of Medical Examiners and the Alabama Board of Nursing.
(2) Systemic analgesics and local anesthetics may be administered under the following conditions:
- (a) The medical staff member who administers the systemic analgesic is legally authorized to do so and shall be present in the birthing center during the use of intravenous analgesics. CPMs may not order or administer narcotic analgesia.
- (b) The dosage and drugs are specifically noted in the protocols for clinical services.
- (c) The use of such drugs is in conformance with the policies and procedures of the birthing center.
- (3) General and conduction anesthesia shall not be administered at birthing centers.
Author: Dana Billingsley, Diane Milledge
Statutory Authority: Code of Ala. 1975, §22-2-2(6), et seq.;
§22-21-20, et seq.
History: Filed November 19, 1987. Repealed: Filed April 16, 2010; effective May 21, 2010. New Rule: Published August 31, 2023; effective October 15, 2023.