1. (a)

   1. (1) Care in freestanding birthing centers shall be provided by a licensed physician and/or CNM and other qualified professionals and clinical staff, with access to and availability of consulting clinical specialists.
   2. (2) Ancillary personnel shall be available to care for the volume of patients and programs offered.

2. (b) Services provided in freestanding birthing centers may include:

   1. (1) Antepartal, intrapartal, and postpartal care; and
   2. (2) The care of the newborn infant.
3. (c) Local analgesia/anesthesia for pudendal block and episiotomy repair shall be permitted.
4. (d) Surgical services shall be limited to those normally performed during uncomplicated childbirth, such as episiotomy and repair of lacerations.
5. (e) The care of the newborn may include a recognized method of circumcision that limits blood loss to less than one cubic centimeter (1 cc).

6. (f) The following shall be prohibited in freestanding birthing centers:

   1. (1) Administration of general and conductive analgesia/anesthesia to include spinal and epidural analgesia/anesthesia;
   2. (2) Administration of all types of conscious sedation;
   3. (3) Performance of Caesarean sections and operative obstetrics to include tubal ligations;
   4. (4) IV analgesia; and
   5. (5) Stimulation or augmentation with chemical agents, e.g., oxytocics during the first and second stages of labor.

Codification Notes: “CNM” means certified nurse midwife. "IV" means intravenous.