20 : 86 : 03 : 04 . Conditions for which a maternal transport to hospital shall be facilitated. A certified professional midwife shall facilitate the immediate transport of a client to a hospital for emergency care if the client has any of the following disorders, diagnosis, conditions or symptoms:

1. (1) Infection during labor or immediately postpartum where maternal temperature is above 100.8 degrees Fahrenheit for two consecutive readings in one hour and one or more of the following are present:

   1. (a) Foul smelling amniotic fluid;
   2. (b) Shaking;
   3. (c) Chills; or
   4. (d) Elevated pulse;
2. (2) Suggestion of fetal jeopardy, such as any abnormal bleeding (withorwithoutabdominalpain), evidence of placental abruption, thick meconium , or abnormal fetal heart tones with non-reassuring patterns where birth is not imminent;
3. (3) Inability to obtain fetal heart tones after 20 weeks gestation or anytime later in pregnancy;
4. (4) Noncephalic presentation at the onset of labor or rupture of membranes, whichever occurs first, unless birth is imminent;
5. (5) Second stage labor after three hours without adequate progress, and third stage labor after one hour without adequate progress;
6. (6) Current spontaneous preterm labor;
7. (7) Current preterm premature rupture of membranes;
8. (8) Signs of pre-eclampsia or eclampsia;
9. (9) Current hypertensive disease of pregnancy;
10. (10) Continuous uncontrolled bleeding;
11. (11) Suspected placenta accreta;
12. (12) Hemorrhage not responsive to treatment;
13. (13) Unresolved maternal shock;
14. (14) Cord prolapse;
15. (15) Active herpes during labor;
16. (16) Transverse in labor;
17. (17) Excessive antepartum and intrapartum painless vaginal bleeding;
18. (18) Cardiac arrest;
19. (19) Delivery injuries to the bladder or bowel including third and fourth degree lacerations;
20. (20) Seizures;
21. (21) Uncontrolled vomiting;
22. (22) Coughing or vomiting of blood;
23. (23) Severe chest pain or cardiac irregularities;
24. (24) Apnea;
25. (25) Persistent uterine atony;
26. (26) Uterine inversion;
27. (27) Indications of infection in the immediate postpartum;
28. (28) Tremors, hyperactivity, or seizures;
29. (29) Declining oxygen stats or tachypnea unable to be resolved; or
30. (30) Client desires transport for herself or her newborn.

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

General Authority: SDCL 36-9C-32(2)(6).

Law Implemented: SDCL 36-9C-36 .