1. (1) Clients registering for care at a birthing center shall receive an orientation and written information regarding the services provided at the birthing center including a statement of client rights in accordance with section (3) of this rule.

2. (2) Each client shall sign, and receive a copy of, a client disclosure form which includes, but is not limited to, the following information:

   1. (a) Services provided to the client and newborn;
   2. (b) Risks, benefits, and eligibility requirements;
   3. (c) Responsibilities of the client and family members or legal representatives;
   4. (d) Fees for services including financial arrangements;
   5. (e) Malpractice coverage or professional liability coverage;
   6. (f) Risk assessment, consultation, and transfer requirements;
   7. (g) Emergency care and transport plan in the event of complications to the client or newborn; and
   8. (h) Identity and qualifications of clinical staff.

3. (3) The statement of client rights shall include, but is not limited to, the following:

   1. (a) Clients shall be treated with courtesy, dignity, respect, privacy, and freedom from abuse;
   2. (b) Clients shall be offered services without discrimination as to race, ethnicity, color, religion, gender identification, sexual orientation, national origin, or source of payment;
   3. (c) Privacy of personal information and confidentiality of health care records;
   4. (d) Clients shall be informed of all laboratory and diagnostic tests, reports, recommendations, and treatments in a timely fashion;
   5. (e) Participation in a plan of care and any changes to the plan of care;
   6. (f) Clients may refuse treatment;
   7. (g) Clients shall be offered nourishment;
   8. (h) Clients shall be informed of screening requirements and referrals to services determined necessary; and
   9. (i) Information on how and where to file a complaint.

4. (4) A birthing center shall:

   1. (a) Provide intrapartum and postpartum care described in sections (6) and (7) of this rule.
   2. (b) Assess the client's risk status throughout pregnancy, labor, and delivery in accordance with OAR 333-077-0125 to determine if care and services in a birthing center, including delivery, is appropriate.
   3. (c) Consult with a provider of perinatal care or other specialty provider in accordance with OAR 333-077-0125.
   4. (d) Provide dietary services in accordance with OAR 333-077-0160.

5. (5) A birthing center that provides prenatal care shall perform regular, periodic prenatal exams and assessments of client and fetus risk status. A prenatal exam shall include at a minimum:

   1. (a) Physical exam;
   2. (b) Urinalysis and other laboratory screenings as determined necessary by the clinical provider;
   3. (c) Discussions about the client's health and newborn's health including good nutrition and how to reduce pregnancy complications and newborn's risk for complications;
   4. (d) Fetal health assessment; and
   5. (e) In third trimester, discussions about preparing for childbirth and classes available;

6. (6) Intrapartum care provided by a birthing center shall include, but is not limited to:

   1. (a) Periodic assessment of the client's physical health and emotional and psychological needs including but not limited to:

      1. (A) Monitoring of vital signs;
      2. (B) Urinalysis if indicated;
      3. (C) Pain assessment; and
      4. (D) Frequency of contractions.

   2. (b) Periodic assessment of the fetus's health including but not limited to:

      1. (A) Monitoring fetal heart rate and fetal movement; and
      2. (B) Abdomen palpation to determine fetal lie and presentation.

   3. (c) Comfort measures including but not limited to:

      1. (A) Physical assistance;
      2. (B) Emotional support; and
      3. (C) Pain relief methods.
   4. (d) Companionship during labor and childbirth with a client's companion of choice.

7. (7) Postpartum care shall consist of periodic assessment of the client's health and newborn's health.

   1. (a) The client health assessment includes but is not limited to:

      1. (A) Physical exam;
      2. (B) Laboratory screening tests, if applicable;
      3. (C) Education in child care including breast or chest feeding, immunization, and referral to sources of pediatric care;
      4. (D) Provision of, or referral to, family planning services; and
      5. (E) Referral to newborn screenings as required in OAR 333-077-0170 if screenings are not provided by the birthing center.

   2. (b) The newborn health assessment includes but is not limited to:

      1. (A) Physical exam;
      2. (B) Laboratory screening tests, if applicable; and
      3. (C) Screenings for newborns in accordance with OAR 333-077-0170.

8. (8) A clinical provider may use telemedicine to provide prenatal and postpartum care to clients after completion of an initial, in-person assessment if no risk factors or complications were identified.

   1. (a) Telemedicine may be conducted through electronic and telecommunication technologies such as video communication, teleconference, landline or wireless communications. Real-time communication between the clinical provider and the client is required.
   2. (b) A clinical provider must ensure that an in-person assessment is completed with the client at least two times between 28 to 36 weeks, and two times between 36 weeks to 39 weeks, 6 days.
   3. (c) Telemedicine may not be conducted after 39 weeks, 6 days.
9. (9) A clinical provider may use a birthing center for both primary care clients and birthing center clients. Client files must be distinct and maintained separately.

Statutory/Other Authority

ORS 441.025

Statutes/Other Implemented

ORS 441.025

History

PH 23-2025, adopt filed 11/03/2025, effective 11/03/2025