A midwife shall accept as a client a woman who has had a previous birth by cesarean section only if:

1. (a) The potential client has had only one previous cesarean section;
2. (b) The midwife can confirm through a review of the records of the previous delivery by cesarean section that the section was performed through a low transverse uterine segment incision;
3. (c) The potential client has had no other uterine surgeries;
4. (d) At least 18 months’ time separates the date of the potential client’s previous cesarean section and the due date of the current pregnancy;
5. (e) An obstetric ultrasound documents that the placenta is not in a low-lying anterior position;
6. (f) The potential client plans to give birth in a location no more than 20 minutes’ drive from a hospital with obstetrical and anesthesia services on call 24 hours a day;

7. (g) The midwife:

   1. (1) Arranges a consultation between the client and an obstetrician affiliated with the hospital closest to the planned location of the birth to discuss the following topics:

      1. a. The information in NNEPQIN's patient education brochure entitled “Birth Choices After Cesarean Section”; and
      2. b. The hospital’s abilities to respond if an emergency transfer from the care of the midwife to the hospital should become necessary; or
   2. (2) Having been refused a consultation for the potential client by every obstetrician affiliated with the hospital closest to the planned location of the birth, records that fact in the potential client's record;
8. (h) The midwife provides the potential client with the information required by Mid 503.04; and
9. (i) The midwife obtains the potential client's signature and date of signing on the informed consent form specified in Mid 503.05.

Source. #7931, eff 8-6-03, EXPIRED: 8-6-11 New. #11095, INTERIM, eff 5-12-16, EXPIRED: 11-8-16 New. #12040, eff 11-10-16