2010 Utah Code
Title 58 - Occupations and Professions
Chapter 77 - Direct-entry Midwife Act
58-77-204 - Administrative rules advisory committee.

58-77-204. Administrative rules advisory committee.
(1) The division shall:
(a) convene an advisory committee to assist the division with developing administrative rules under Section 58-77-601; and
(b) provide notice of any meetings convened under Subsection (1)(a) to the members of the advisory committee at least one week prior to the meeting, if possible.
(2) The advisory committee shall include:
(a) two physicians:
(i) licensed under Chapter 67, Utah Medical Practices Act, or Chapter 68, Utah Osteopathic Medical Practice Act; and
(ii) selected by the Utah Medical Association;
(b) one licensed certified nurse midwife recommended by the Utah Chapter of the American College of Nurse Midwives; and
(c) three licensed Direct-entry midwives, selected by the board.
(3) (a) The division shall submit the following to the advisory committee:
(i) administrative rules adopted by the division prior to March 1, 2008 under the provisions of Section 58-77-601; and
(ii) any administrative rule proposed by the division after March 1, 2008 under the provisions of Section 58-77-601.
(b) If the division does not incorporate a recommendation of the advisory committee into an administrative rule, the division shall provide a written report to the Legislative Administrative Rules Review Committee which explains why the division did not adopt a recommendation of the advisory committee.
(4) The division shall adopt administrative rules regarding conditions that require:
(a) mandatory consultation with a physician licensed under Chapter 67, Utah Medical Practice Act, or Chapter 68, Utah Osteopathic Medical Practice Act, upon:
(i) miscarriage after 14 weeks;
(ii) failure to deliver by 42 completed weeks of gestation;
(iii) a baby in the breech position after 36 weeks gestation;
(iv) any sign or symptom of:
(A) placenta previa; or
(B) deep vein thrombosis or pulmonary embolus; or
(v) any other condition or symptom that may place the health of the pregnant woman or unborn child at unreasonable risk as determined by the division by rule;
(b) mandatory transfer of patient care before the onset of labor to a physician licensed under Chapter 67, Utah Medical Practice Act, or Chapter 68, Utah Osteopathic Medical Practice Act, upon evidence of:
(i) placenta previa after 27 weeks;
(ii) diagnosed deep vein thrombosis or pulmonary embolism;
(iii) multiple gestation;
(iv) no onset of labor after 43 completed weeks of gestation;
(v) more than two prior c-sections, unless restricted by the division by rule;
(vi) prior c-section with a known classical or inverted-T or J incision;
(vii) prior c-section without an ultrasound that rules out placental implantation over the uterine scar;

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(viii) prior c-section without a signed informed consent document detailing the risks of vaginal birth after caesarean;
(ix) prior c-section with a gestation greater than 42 weeks;
(x) Rh isoimmunization with an antibody titre of greater than 1:8 in a mother carrying an Rh positive baby or a baby of unknown Rh type;
(xi) any other condition that could place the life or long-term health of the pregnant woman or unborn child at risk;
(c) mandatory transfer of care during labor and an immediate transfer in the manner specifically set forth in Subsections 58-77-601(4)(a), (b), or (c) upon evidence of:
(i) undiagnosed multiple gestation, unless delivery is imminent;
(ii) prior c-section with cervical dilation progress in the current labor of less than 1 cm in three hours once labor is active;
(iii) fetus in breech presentation during labor unless delivery is imminent;
(iv) inappropriate fetal presentation as determined by the licensed Direct-entry midwife;
(v) non-reassuring fetal heart pattern indicative of fetal distress that does not immediately respond to treatment by the Direct-entry midwife unless delivery is imminent;
(vi) moderate thick, or particulate meconium in the amniotic fluid unless delivery is imminent;
(vii) failure to deliver after three hours of pushing unless delivery is imminent; or
(viii) any other condition that could place the life or long-term health of the pregnant woman or unborn child at significant risk if not acted upon immediately; and
(d) mandatory transfer of care after delivery and immediate transfer of the mother or infant in the manner specifically set forth in Subsections 58-77-601(4)(a), (b), or (c) upon evidence of any condition that could place the life or long-term health of the mother or infant at significant risk if not acted upon immediately.
(5) Members appointed to the advisory committee created in this section may also serve on the Licensed Direct-entry Midwife Board established under this chapter.
(6) The director shall make appointments to the committee by July 1, 2008.
(7) The director of the division shall appoint one of the three licensed Direct-entry midwives and one of the non-Direct-entry midwife members to serve as co-chairs of the committee.
(8) A committee member shall serve without compensation and may not receive travel costs or per diem for the member's service on the committee.
(9) (a) The committee shall recommend rules under Subsection (1) based on convincing evidence presented to the committee, and shall strive to maintain medical self-determination.
(b) A majority of members constitute a quorum.
(10) This section is repealed on July 1, 2011.

Enacted by Chapter 365, 2008 General Session