| (a) Using reasonable skill and knowledge, the midwife
shall assess the mother during the immediate postpartum period by
monitoring vital signs, uterine fundus, bleeding and subjective status
for a minimum of two hours after mother's condition is stable as indicated.
(b) Using reasonable skill and knowledge, the midwife
shall:
(1) collect, assess and document maternal care data
throughout the postpartum period including history, physical exam,
laboratory testing;
(2) develop and implement a plan of care;
(3) evaluate the client's condition on an ongoing basis
and modify the plan of care as necessary; and
(4) provide health education/counseling.
(c) If on any postpartum assessment one of the following
conditions exists, the midwife shall recommend referral to an appropriate
health care professional and document that recommendation in the midwifery
record:
(1) infection requiring antimicrobial therapy;
(2) bladder dysfunction;
(3) major depression; or
(4) any other condition or symptom which could threaten
the health of the mother, as assessed by a midwife exercising reasonable
skill and knowledge.
(d) If on any postpartum assessment one of the following
conditions exists, the midwife shall initiate immediate emergency
transfer, initiate emergency care as indicated by the situation, continue
care as needed, and document that action in the midwifery record:
(1) uncontrolled hemorrhage;
(2) maternal shock;
(3) any hypertensive disorder, including preeclampsia/eclampsia;
(4) signs of thrombophlebitis or pulmonary embolism;
or
(5) any other condition or symptom which could threaten
the life of the mother, as assessed by a midwife exercising reasonable
skill and knowledge.
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