105 C.M.R. 140.905 – Care and Services

(A) The birth center shall provide a program of care, which includes at least the following:
1. (1) A personal and family history;
2. (2) A physical examination and appropriate laboratory tests;
3. (3) A program of prenatal care that shall include components of self-help, self-care, and fetal assessment;
4. (4) A program of prenatal education that shall include the importance of nutrition, preparation for birth and breast or chest feeding, and information on adverse effects of smoking, alcohol and other drugs;
5. (5) Intrapartum and postpartum services that foster parental control and responsibility for the birth experience and infant parental bonding;
6. (6) Labor support for the pregnant person and their family;
7. (7) Immediate postpartum care and newborn assessment;
8. (8) Required eye prophylaxis;
9. (9) Postpartum laboratory examination;
10. (10) Newborn metabolic screening and other such tests as may be required;
11. (11) A postpartum examination, including perinatal mood disorder screening, and family planning;
12. (12) A plan for routine gynecologic health care; and
13. (13) A program for prevention of Rh immunization.
(B) The birth center shall have access to diagnostic services, including clinical laboratory, sonography, radiology, and electronic monitoring.
(C) Birthing persons and infants may be discharged or transferred within 24 hours after birth.
(D) Maternal and newborn examinations shall be performed by the birth center professional staff or a physician or certified nurse-midwife of the family's choice within 72 hours of birth. Such examinations shall include required laboratory tests for health screening.
(E) Each birth center shall develop and implement written policies and procedures for the prompt and safe transfer of the obstetrical patient and of the newborn for emergency treatment beyond that provided in the birth center.
(F) Each birth center shall have written policies and procedures for the coordination of ongoing care and transfer of patients to hospitals for treatment beyond that provided by the birth center which must include, at a minimum, the process for providing the patients' medical records to the hospital at the time of transfer.
(G) A birth center must conduct newborn infant hearing screening in accordance with the requirements regarding screening at 105 CMR 130.616(D)(2)(I): Universal Newborn Hearing Screening Programs. If a birth center does not have the equipment or ability to conduct such a screening, the birth center shall refer the newborn infant to a hospital or clinic able to conduct such screening. Prior to discharge, a birth center that is not able to conduct a hearing screening shall:
1. (1) make an appointment for a screening for each newborn infant at a screening site.
2. (2) provide written information in the language understood by the parent or guardian to the parent or guardian about the importance of the screening, coverage of the costs of the screening by third-party payers, the time of any screening appointment scheduled, and the location and phone number of the hearing screening site.
3. (3) within two weeks of the birth of a child, confirm the hearing screening has been completed and, if not, contact the parent or guardian of the newborn infant.
4. (4) As part of the annual report submitted to the Department pursuant to 105 CMR 130.616(D)(2)(I): Universal Newborn Hearing Screening Programs, the birth center shall submit information regarding the follow-up for hearing screening of newborn infants.
(H) The administration of medications for pregnancy termination or early pregnancy loss, including but not limited to mifepristone and/or misoprostol, to birth center patients is permissible in the birth center.