(a) A midwife shall consult with, refer to, collaborate with, or transfer to an appropriate healthcare provider or facility in accordance with the Act and this chapter.     
      (b) If a client who is at a low risk of developing complications elects not to accept a referral or a physician or associate's advice, the midwife shall:      
        (1) continue to care for the client after discussing and documenting the risks in the midwifery record, which shall include informing the client that her condition may worsen and require transfer;       
        (2) seek a consultation;       
        (3) manage the client in collaboration with an appropriate health care professional; or       
        (4) terminate care.       
      (c) If a midwife administers any prescription medication to a client or her newborn other than oxygen and eye prophylaxis, the midwife must do so in accordance with standing delegation orders from and under the supervision of a physician. The midwife shall ensure that the orders are current (renewed annually) and comply with state law and the rules of the Texas Medical Board.     
     Source Note:        The provisions of this §115.111 adopted to be effective May 1, 2019, 44 TexReg 1849