20 : 86 : 03 : 01 . Scope and practice standards. A licensed certified professional midwife shall adhere to the scope and practice standards when providing antepartum, intrapartum, postpartum, an d ne wborn care. The following are conditions for which a licensed professional midwif e may not provide care for a client:

1. (1) A current or unresolved previous history of any of the following disorders, diagnoses, conditions, or symptoms:

   1. (a) Placental abnormality:

      1. (i) Confirmed central placenta previa at term;
      2. (ii) Signs indicative of placental abruption; or
      3. (iii) Placenta located over previous uterine scar;
   2. (b) Regular alcohol use or drug use, abuse, or dependency;
   3. (c) Cardiac disease;
   4. (d) Diabetes requiring medication, including gestational diabetes and Type II diabetes;
   5. (e) Noncephalic presentation at the onset of labor or rupture of membranes, whichever occurs first, unless birth is imminent;
   6. (f) Birth under 37 weeks or after 42 weeks gestational age;
   7. (g) Current renal disease;
   8. (h) Current liver disease;
   9. (i) Pulmonary disease;
   10. (j) Active tuberculosis;
   11. (k) Severe uncontrolled asthma;
   12. (l) Seizure disorder requiring medication;
   13. (m) Systemic lupus or scleroderma;
   14. (n) Acute or chronic hepatitis;
   15. (o) Congenital defects of the reproductive organs that would interfere with the birthing process;
   16. (p) Chronic/essential hypertension;
   17. (q) Gestational hypertension or pre-eclampsia;
   18. (r) Rh negative disease as indicated by positive titers;
   19. (s) TORCH infection including toxoplasmosis, rubella, cytomegalovirus, parvovirus, and varicella and other infections including syphilis, active genital herpes, listeria, and zika during the first trimester;
   20. (t) HIV positive;
   21. (u) Suspected or diagnosed congenital fetal anomaly that may require immediate medical care after birth;
   22. (v) Hemoglobin less than 10 at 36 weeks;
   23. (w) Preterm labor: less than 37 weeks;
   24. (x) Any acute infection at the time of delivery that would put the newborn at risk of becoming very sick; or
   25. (y) Suspected intrauterine growth restriction;

2. (2) A past history of any of the following disorders, diagnoses, conditions, or symptoms:

   1. (a) More than one prior cesarean section with no history of a vaginal birth, a cesarean section within 18 months of the current delivery, or any cesarean section that was surgically closed with a classical or vertical uterine incision; or
   2. (b) Rh or other blood group or platelet sensitization, hematological or coagulation disorders including thrombocytopenia (platelets less than 150,000);
3. (3) Failure to obtain minimum prenatal lab work, including blood group type, RH antibody screening, hemoglobin, and syphilis around 28 weeks gestation;

4. (4) Failure to document:

   1. (a) Lab work for HIV and hepatitis B around 28 weeks gestation; or
   2. (b) A signed HIV and Hepatitis B Informed Refusal form provided by the board;
5. (5) Unwillingness to accept midwife's limitations, prohibitions, and responsibilities for safe practice;
6. (6) Unresolved fearfulness regarding home birth or midwife care, or otherwise desires transfer of care; or
7. (7) Any other condition which may preclude the possibility of a normal birth, at the midwife's discretion.

Source: 45 SDR 31 , effective September 10, 2018 .

General Authority: SDCL 36-9C-32(2).

Law Implemented: SDCL 36-9C-13 .