(a) Labor and birth shall be managed and attended by a birth attendant.
(b) The birth attendant shall be trained in the use of emergency equipment.
(c) A center shall ensure that its birth attendants encourage a client to seek medical care if the birth attendant recognizes a sign or symptom of a complication to the client's childbirth.
(d) Other clinical care provider(s) and/or a birth attendant, shall be physically present in the center whenever a client is in the center until the client is discharged. The clinical care provider shall be capable of performing the following minimum duties:
  (1) monitoring the fetal heartbeat;
  (2) monitoring the mother's blood pressure, pulse, and temperature;
  (3) performing adult and infant cardiopulmonary resuscitation, if needed;
  (4) monitoring the newborn's heart rate, respiratory rate and body temperature; and
  (5) assessing the client's fundus and blood loss.
(e) A birth attendant shall be physically present to conduct the delivery and be available during the acute postpartum period.
(f) Interventions shall be limited to those required to accomplish a vaginal delivery.
(g) No general, epidural, or subdural anesthetic agent shall be administered in a center.

Source Note: The provisions of this §137.48 adopted to be effective December 2, 2007, 32 TexReg 8507