These risk assessment strategies are not a set of mandatory protocols, and do not mandate specific clinical interventions, rather, they are a set of standard recommendations which may highlight areas that require midwifery attention and appropriate responses.

1. (a) Antepartum Risk Assessment. Antepartum risk assessment may include, but is not limited to:

   1. 1. Obtain and evaluate a maternal history.
   2. 2. Assessment of maternal nutritional status.
   3. 3. Assessment of maternal social and emotional well-being.
   4. 4. Recommendation, referral, performance, and/or evaluation of appropriate laboratory and imaging studies and antepartum surveillance methodology.
   5. 5. Continued identification of risk by initial and interval assessments.
   6. 6. Evaluation, management, and follow-up of complications.

2. (b) Intrapartum Risk Assessment. Intrapartum risk assessment may include, but is not limited to:

   1. 1. Assessment and documentation of gestational age and presentation of the fetus at the initiation of active labor.
   2. 2. Continued identification of risk by initial and interval assessments of labor pattern and fetal and maternal well-being.
   3. 3. Evaluation, management, and follow-up of complications.

3. (c) Postpartum and Newborn Risk Assessment. Postpartum and newborn risk assessment may include, but is not limited to:

   1. 1. Performance and evaluation of a newborn physical examination.
   2. 2. Utilization of appropriate level of neonatal care.
   3. 3. Assessment of breastfeeding.
   4. 4. Recommendation, referral, performance, and/or evaluation of appropriate laboratory and postpartum and newborn surveillance methodology.
   5. 5. Continued identification of risk by initial and interval assessments of maternal and infant status.
   6. 6. Evaluation, management, and follow-up of complications.

Author: Alabama State Board of Midwifery

Statutory Authority: Code of Ala. 1975, §§34-19-14, et seq.

History: New Rule: Filed September 24, 2018; effective November 9, 2018.