24 Del. Admin. Code § 1795-6.0

Current through Register Vol. 28, No. 5, November 1, 2024

Section 1795-6.0 - Prenatal Care

6.1 During prenatal care, the midwife or other licensed health care provider shall follow a regular schedule of prenatal care with increasing frequency towards term. The responsibilities of the midwife during this time include:

6.1.1 Initial Prenatal Visit:

6.1.1.1 History and assessment of general health;

6.1.1.2 History and assessment of obstetric and psychosocial status;

6.1.1.3 Discussion of current CDC recommendations for immunization during pregnancy;

6.1.1.4 Physical Exam, including:

6.1.1.4.1 Height;

6.1.1.4.2 Weight;

6.1.1.4.3 Blood pressure;

6.1.1.4.4 Pulse;

6.1.1.4.5 Breast exam;

6.1.1.4.6 Abdomen, to include fundal height, fetal heart tones, fetal lie, and presentation;

6.1.1.4.7 Estimation of gestational age;

6.1.1.4.8 Assessment of varicosities, edema, and reflexes.

6.1.1.5 The midwife must complete the following laboratory tests at the initial prenatal visit:

6.1.1.5.1 Hemoglobin or hematocrit or CBC;

6.1.1.5.2 Urinalysis for protein and glucose;

6.1.1.5.3 Syphilis serology;

6.1.1.5.4 Blood group, Rh type, and antibody screen;

6.1.1.5.5 Hepatitis B surface antigen;

6.1.1.5.6 Rubella screen;

6.1.1.5.7 Gonorrhea test;

6.1.1.5.8 Chlamydia test;

6.1.1.5.9 HIV test;

6.1.1.5.10 Urine culture.

6.1.1.6 The midwife must provide appropriate prophylactic antibiotic therapy for GBS positive clients pursuant to CDC guidelines.

6.1.1.7 The midwife should consider genetic testing, urine drug screen, and Hepatitis C testing as indicated.

6.1.2 On-going Prenatal Care:

6.1.2.1 Assessment of general health;

6.1.2.2 Assessment of psychosocial health;

6.1.2.3 Nutritional counseling;

6.1.2.4 Physical Exam to include, but not limited to:

6.1.2.4.1 Blood pressure;

6.1.2.4.2 Weight;

6.1.2.4.3 Abdomen, to include fundal height, fetal heart tones, fetal lie, and presentation;

6.1.2.4.4 Estimation of gestational age by physical findings;

6.1.2.4.5 Assessment of varicosities, edema and reflexes.

6.1.2.5 The midwife must offer the following laboratory tests:

6.1.2.5.1 Hemoglobin, hematocrit, or CBC between 28 and 32 weeks;

6.1.2.5.2 Gross urinalysis for protein and glucose at each visit;

6.1.2.5.3 Glucose Tolerance Test;

6.1.2.5.4 Group Beta Strep (GBS) cultures, according to CDC guidelines. If penicillin allergic, determine antibiotics to which the strain of GBS carried by the client is sensitive and treat appropriately during labor;

6.1.2.5.5 Herpes (HSV 1 or HSV 2) cultures, if indicated;

6.1.2.5.6 Prophylactic Rh-immune globulin information for Rh negative clients;

6.1.2.5.7 Urine Drug Screen.

24 Del. Admin. Code § 1795-6.0

20 DE Reg. 62 (7/1/2016) (Final)