{"data":{"id":"us-md/md.-code-health-occupations-8-6c-02","jurisdiction":"us-md","citation":"Md. Code, Health Occupations § 8–6C–02","heading":"","body":"(a) The practice of direct–entry midwifery includes:\n(1) Providing the necessary supervision, care, and advice to a patient during a low–risk pregnancy, labor, delivery, and postpartum period; and\n(2) Newborn care authorized under this subtitle that is provided in a manner that is:\n(i) Consistent with national direct–entry midwifery standards; and\n(ii) Based on the acquisition of clinical skills necessary for the care of pregnant women and newborns, including antepartum, intrapartum, and postpartum care.\n(b) The practice of direct–entry midwifery also includes:\n(1) Obtaining informed consent to provide services to the patient;\n(2) Discussing:\n(i) Any general risk factors associated with the services to be provided;\n(ii) Any specific risk factors pertaining to the health and circumstances of the individual patient;\n(iii) Conditions that preclude care by a licensed direct–entry midwife; and\n(iv) The conditions under which consultation, transfer of care, or transport of the patient must be implemented;\n(3) Obtaining a health history of the patient and performing a physical examination;\n(4) Developing a written plan of care specific to the patient, to ensure continuity of care throughout the antepartum, intrapartum, and postpartum periods, that includes:\n(i) A plan for the management of any specific risk factors pertaining to the individual health and circumstances of the individual patient; and\n(ii) A plan to be followed in the event of an emergency, including a plan for transportation;\n(5) Evaluating the results of patient care;\n(6) Consulting and collaborating with a health care practitioner regarding the care of a patient, and referring and transferring care to a health care provider, as required;\n(7) Referral of all patients, within 72 hours after delivery, to a pediatric health care practitioner for care of the newborn;\n(8) As approved by the Board:\n(i) Obtaining and administering medications; and\n(ii) Obtaining and using equipment and devices;\n(9) Obtaining appropriate screening and testing, including laboratory tests, urinalysis, and ultrasound;\n(10) Providing care during the antepartum period, with consultation or referral as required;\n(11) Providing care during the intrapartum period, including:\n(i) Monitoring and evaluating the condition of the patient and fetus;\n(ii) Performing emergency procedures, including:\n1. Administering approved medications;\n2. Administering intravenous fluids for stabilization;\n3. Performing an emergency episiotomy; and\n4. Providing care while on the way to a hospital under circumstances in which emergency medical services have not been activated;\n(iii) Activating emergency medical services for an emergency; and\n(iv) Delivering in an out–of–hospital setting;\n(12) Participating in peer review as required under § 8–6C–18(e)(2) of this subtitle;\n(13) Providing care during the postpartum period, including:\n(i) Suturing of first and second degree perineal or labial lacerations, or suturing of an episiotomy with the administration of a local anesthetic; and\n(ii) Making further contact with the patient within 48 hours, within 2 weeks, and at 6 weeks after the delivery to assess for hemorrhage, preeclampsia, thrombo–embolism, infection, and emotional well–being;\n(14) Providing routine care for the newborn for up to 72 hours after delivery, exclusive of administering immunizations, including:\n(i) Immediate care at birth, including resuscitating as needed, performing a newborn examination, and administering intramuscular vitamin K and eye ointment for prevention of ophthalmia neonatorum;\n(ii) Assessing newborn feeding and hydration;\n(iii) Performing metabolic screening and reporting on the screening in accordance with the regulations related to newborn screenings that are adopted by the Department;\n(iv) Performing critical congenital heart disease screening and reporting on the screening in accordance with the regulations related to newborn screenings that are adopted by the Department;\n(v) If unable to perform the screening required under item (iii) or (iv) of this item, referring the newborn to a pediatric health care practitioner to perform the screening within 24 to 48 hours after delivery; and\n(vi) Referring the infant to an audiologist for a hearing screening in accordance with the regulations related to newborn screenings that are adopted by the Department;\n(15) Within 24 hours after delivery, notifying a pediatric health care practitioner of the delivery;\n(16) Within 72 hours after delivery:\n(i) Transferring health records to the pediatric health care practitioner, including documentation of the performance of the screenings required under item (14)(iii) and (iv) of this subsection; and\n(ii) Referring the newborn to a pediatric health care practitioner;\n(17) Providing the following care of the newborn beyond the first 72 hours after delivery:\n(i) Weight checks and general observation of the newborn’s activity, with abnormal findings communicated to the newborn’s pediatric health care practitioner;\n(ii) Assessment of newborn feeding and hydration; and\n(iii) Lactation support and counseling; and\n(18) Providing limited services to the patient after the postpartum period, including:\n(i) Lactation support and counseling; and\n(ii) Counseling and referral for all family planning methods.\n(c) The practice of direct–entry midwifery does not include:\n(1) Pharmacological induction or augmentation of labor or artificial rupture of membranes prior to the onset of labor;\n(2) Surgical delivery or any surgery except an emergency episiotomy;\n(3) Use of forceps or vacuum extractor;\n(4) Except for the administration of a local anesthetic, administration of an anesthetic;\n(5) Administration of any kind of narcotic analgesic; or\n(6) Administration of any prescription medication in a manner that violates this subtitle.\n(d) The practice of direct–entry midwifery is independent and does not require oversight by another health care practitioner.","path":["Article - Health Occupations"],"source_url":"https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gho\u0026section=8-6C-02","current_through":"2026-01-01","vintage":"","retrieved_at":"2026-09-14T19:58:58Z","sha256":"9bc1ef23895302a996209ef646792211fc9bd455d90ce94127e625f2b35e7ccf","source_id":"us-md","stale":false,"prev":"us-md/md.-code-health-occupations-8-6c-01","next":"us-md/md.-code-health-occupations-8-6c-03"},"notice":"GroundRules: Original legal text. Not legal advice."}