(1) The board may approve a direct-entry midwife program or course of study which shall include instruction in a core program which requires each student to demonstrate competence in each of the following substantive content areas:

(a) antepartum care, including:

(i) preconceptional factors likely to influence pregnancy outcome;

(ii) basic genetics, embryology and fetal development;

(iii) anatomy and assessment of the soft and bony structure of the pelvis;

(iv) identification and assessment of the normal changes of pregnancy, fetal growth and position;

(v) nutritional requirements for pregnant women and methods of nutritional assessment and counseling;

(vi) environmental and occupational hazards for pregnant women;

(vii) education and counseling to promote health throughout the childbearing cycle;

(viii) methods of diagnosing pregnancy;

(ix) the etiology, treatment and referral, when indicated, of the common discomforts of pregnancy;

(x) assessment of physical and emotional status, including relevant historical and psychosocial data;

(xi) counseling for individual birth experiences, parenthood and changes in the family;

(xii) indications for, risks and benefits of screening/diagnostic tests used during pregnancy;

(xiii) etiology, assessment of, treatment for and appropriate referral for abnormalities of pregnancy;

(xiv) identification of, implications of and appropriate treatment for various STD/vaginal infections during pregnancy;

(xv) special needs of the Rh negative woman; and

(xvi) identification and care of women who are HIV positive, have hepatitis or other communicable and noncommunicable diseases.

(b) intrapartum care, including:

(i) normal labor and birth processes;

(ii) anatomy of the fetal skull and its critical landmarks;

(iii) parameters and methods for assessing maternal and fetal status, including relevant historical data;

(iv) emotional changes and support during labor and delivery;

(v) comfort and support measures during labor, birth, and immediately postpartum;

(vi) techniques to facilitate the spontaneous vaginal delivery of the baby and placenta;

(vii) etiology, assessment of, appropriate referral or transport of and/or emergency measures (when indicated) for the mother or newborn for abnormalities of the four stages of labor;

(viii) anatomy, physiology, and supporting normal adaptation of the newborn to extrauterine life;

(ix) familiarity with medical interventions and technologies used during labor and birth; and

(x) assessment and care of the perineum and surrounding tissues, including suturing necessary for perineal repair.

(c) postpartum care, including:

(i) anatomy and physiology of the postpartum period;

(ii) anatomy and physiology and support of lactation, and appropriate breast care and assessment;

(iii) parameters and methods for assessing and promoting postpartum recovery;

(iv) etiology and methods for managing the discomforts of the postpartum period;

(v) emotional, psychosocial and sexual changes which may occur postpartum;

(vi) nutritional requirement for women during the postpartum period;

(vii) etiology, assessment of, treatment for and appropriate referral for abnormalities of the postpartum period;

(viii) methods to assess the success of the breastfeeding relationship and identify lactation problems, and mechanisms for making appropriate referrals;

(ix) suturing necessary for episiotomy repair;

(x) dispensing and administering pitocin (intramuscular) postpartum; and

(xi) dispensing and administering xylocaine (subcutaneous).

(d) neonatal care, including:

(i) anatomy and physiology of the newborn's adaptation and stabilization in the first hours and days of life;

(ii) parameters and methods for assessing newborn status, including relevant historical data at gestational age;

(iii) nutritional needs of the newborn;

(iv) ARM and MCA standards for an administration of prophylactic treatments commonly used during the neonatal period;

(v) ARM and MCA standards for indications, risks and benefits of, and method of performing common screening tests for the newborn; and

(vi) etiology, assessment of (including screening and diagnostic tests), emergency measures and appropriate transport/referral or treatments for neonatal abnormalities.

(e) health and social sciences, including:

(i) communication, counseling and teaching techniques, including the areas of client education and interprofessional collaboration;

(ii) human anatomy and physiology relevant to human reproduction;

(iii) ARM and MCA standards of care, including midwifery and medical standards for women during the childbearing cycle;

(iv) interprofessional communication and collaboration with community health and social resources for women and children;

(v) significance of and methods for thorough documentation of client care through the childbearing cycle;

(vi) informed decision making;

(vii) health education, health promotion, and self care;

(viii) the principles of clean and aseptic techniques, and universal precautions;

(ix) psychosocial, emotional and physical components of human sexuality, including indications of common problems and method of counseling;

(x) ethical considerations relevant to reproductive health;

(xi) epidemiologic concepts and terms relevant to perinatal and women's health;

(xii) the principles of how to access and evaluate current research relevant to midwifery practice;

(xiii) family centered care, including maternal, infant and family bonding;

(xiv) identification of an appropriate referral of disease in women and their families; and,

(xv) the importance of accessibility, quality health care for all women that includes continuity of care, and special requirements for home births.

(2) The applicant shall submit certificates of completion or certified transcripts sent directly from the institution, as verification the education is equivalent to or exceeds the minimum direct-entry midwife educational standards required by the board's laws and rules.

(3) The applicant shall submit course and program descriptions, from the time of applicant's graduation or completion, found in pertinent institution catalogs and brochures, to verify the training received fulfills minimum direct-entry midwife educational standards.

(4) The board reserves the right to evaluate individual applications as to their compliance with equivalent direct-entry midwife educational standards, on a case-by-case basis, in the sole discretion of the board.

History: 37-27-105, MCA; IMP, 37-27-201, MCA; NEW, 1992 MAR p. 2722, Eff. 12/25/92; TRANS, from Commerce, 2001 MAR p. 1642.