(1) The rights and responsibilities of the patient and family, however defined, shall be clearly delineated in the birthing center's policies and procedures and communicated on the patient's admission for care. All patients have a right to:
- (a) Be treated with respect, dignity, and consideration.
- (b) Be assured of confidentiality.
- (c) Be informed of the benefits, risks, and eligibility requirements for care in the birthing center.
- (d) Be informed of the services provided by the birthing center and those provided by contract, consultation, and referral.
- (e) Be informed of the identity and qualifications of care providers, consultants, and related services and institutions.
- (f) Have access to their medical records and all results of screening or diagnostic studies.
- (g) Be informed of all diagnostic procedures and reports, recommendations, and treatments.
- (h) Participate in decisions relating to the plan for management of the patient's care and all changes in that plan, once established, including referral or transfer to other practitioners or other levels of care.
- (i) Receive a written statement of fees for services and responsibilities for payment.
- (j) Be informed of the birthing center's plan for the provision of emergency and nonemergency care in the event of complications to mother or newborn.
- (k) Receive a written statement of the birthing center's plan and the family's responsibility to ensure adequate supportive home care and follow-up health supervision of the mother and infant.
- (l) Be informed of, and reserve the right to refuse, participation in research or student education programs.
- (m) Be informed of the birthing center's policy for hearing grievances. The telephone number to register complaints with the Alabama Department of Public Health, Division of Health Care Facilities, shall be posted in a prominent location and shall be included in the written material given to the patient upon discharge. A grievance log, including the nature of the complaint and its resolution, shall be maintained by the birthing center and made available for inspection by the Department on its request.
- (n) Be informed of the liability insurance status of the birthing center and medical staff.
(2) The birthing center shall provide or demonstrate its availability to provide a range of services to meet the physical, emotional, socio-economic, informational, and medical needs of the individual patient while under care, including, but not limited to:
- (a) An orientation to the facility fees and services of the birthing center.
- (b) Written information, including a glossary of terms, on the established criteria for admission to, and continuation in, the birthing center's program of care.
- (c) Prenatal care (may be provided at a related practitioner or clinic site).
- (d) A program of education for pregnancy, labor, breastfeeding, infant care, early discharge, parenting, self-care/self-help, and sibling preparation.
- (e) Laboratory services.
- (f) Twenty-four (34) hour telephone consultation services.
- (g) Intrapartum care.
(h) Light nourishment during labor and postpartum.
- 1. When patients remain in the birthing center for 24 hours, food must be provided to meet the dietary needs of those patients. If meals are prepared in the birthing center, the facility shall have organized dietary services that are directed and staffed by adequate qualified personnel, including a qualified food service manager and consultation by a licensed registered dietician as required to meet the dietary needs of the patients. However, a birthing center that has a contract with an outside food management company may meet the requirements of this rule if the company has a dietitian who serves the birthing center on a full-time, part-time, or consultant basis, and if the company maintains at least the minimum standards specified in this rule and provides for constant liaison with the birthing center medical staff for recommendations on dietetic policies affecting patient treatment.
2. Food prepared outside the facility shall be performed only by facilities which meet the requirements of Alabama Administrative Code, Chapter 420-3-14, Food Service Sanitation. In addition, the birthing center must provide a food preparation area with:
• Double sink, if disposable are not utilized at all times.
• Microwave oven.
• Refrigerator.
• Hand-washing sink.
• Counter space.
• Towel cabinet.
• Soap dispenser.
• Garbage cans with cover.
• Coffee maker.
• Storage area for silverware and cutlery, if disposables are not utilized at all times.
- (i) Immediate post partum care.
- (j) Home or office follow-up for mother and newborn.
(k) Additional options:
- 1. Exercise p0rograms.
- 2. Parent support groups.
- 3. Postpartum classes.
- 4. Family planning.
- 5. Well baby care.
- 6. Circumcision.
- 7. Nursing mother support programs.
- 8. Well woman gynecologic care.
- 9. Public education.
- 10. Professional education.
- 11. Clinical investigation and/or research.
- (3) The birthing center shall inform patients that drugs for induction or augmentation of labor, vacuum extractors, and forceps are not necessary during normal labor and are not appropriate for use in birthing centers. Patients must be provided with and consent to this policy.
- (4) The birthing center's policy and procedure manual shall include all aspects of birthing center practice and care and shall be made available to practitioners and support staff at all times.
- (5) The birthing center's practice protocols must be approved by the staff physician or consultant physician and made available to the hospital receiving transfers upon request.
Author: Dana Billingsley, Denise 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.