|(a) Purpose. To establish standards for safe midwifery
(b) Midwifery is the practice by a midwife of giving
the necessary supervision, care, and advice to a woman during normal
pregnancy, labor and the postpartum period; conducting a normal delivery
of a child; and providing normal newborn care.
(c) Midwifery practice is based upon education in the
sciences and upon necessary clinical skills as defined in §831.11
of this title (relating to License Required) and §831.32 of this
title (relating to Basic Midwifery Education). The education shall
be obtained through apprenticeship or an approved basic midwifery
(d) Midwifery care is provided by qualified practitioners.
(1) is regulated by the Texas Midwifery Board; and
(2) is in compliance with the legal requirements of
the State of Texas while practicing in the state.
(e) Midwifery care supports individual rights and self-determination
within the boundaries of safety. Using reasonable skill and knowledge,
the midwife shall:
(1) provide clients with a description of the scope
of midwifery services and information regarding the client's rights
and responsibilities in accordance with §203.351 of the Texas
(2) assess the client on an ongoing basis for any factors
which might preclude a client from admission into or continuing in
(3) provide clients with information about other providers
and services when requested or when the care required is not within
the scope of practice of midwifery; and
(4) practice in accordance with the knowledge, clinical
skills, and judgments described in the Midwives Alliance of North
America (MANA) Core Competencies for Basic Midwifery Practice, adopted
August 4, 2011 within the bounds of the midwifery scope of practice
as defined by the Act; and the Texas Midwifery Board Standards for
the Practice of Midwifery in Texas.
(f) The midwife shall provide care in a safe and clean
environment. The midwife shall:
(1) carry, and use, when needed, resuscitation equipment;
(2) use universal precautions for infection control.
(g) Midwifery care is documented in legible, complete
health records. The midwife shall:
(1) maintain records that completely and accurately
document the client's history, physical exam, laboratory test results,
antepartum visits, consultation reports, referrals, labor, delivery,
postpartum visits, and neonatal evaluations at the time midwifery
services are delivered and when reports are received;
(2) grant clients access to their records within 30
days of the date the request is received;
(3) provide a mechanism for sending a copy of the health
record upon referral or transfer to other levels of care;
(4) maintain the confidentiality of client records;
(5) maintain records:
(A) for the mother, for a minimum of five years; and
(B) for the infant, until the age of majority.
(h) Midwifery care includes documentation of a periodic
process of evaluation and quality assurance of midwifery practice.
The midwife shall:
(1) collect client care data systematically and be
involved in analysis of that data for the evaluation of the process
and outcome of care;
(2) review problems identified by the midwife or by
other professionals or consumers in the community; and
(3) act to resolve problems that are identified.
|Source Note: The provisions of this §831.51 adopted to be effective April 24, 2003, 28 TexReg 3327; amended to be effective September 2, 2007, 32 TexReg 5371; amended to be effective March 11, 2013, 38 TexReg 1689