SECTION 115.1. Definitions

The following words and terms when used in this chapter have the following meaning unless the context clearly indicates otherwise.

(1) Act--The Texas Midwifery Act, Texas Occupations Code, Chapter 203.

(2) Advisory Board--The Midwives Advisory Board appointed by the presiding officer of the Commission with the approval of the Commission.

(3) Appropriate health care facility--The Department of State Health Services, a local health department, a public health district, a local health unit or a physician's office where specified tests can be administered and read, and where other medical/clinical procedures normally take place.

(4) Basic midwifery education course--A course approved by the department to fulfill the education requirement for obtaining an initial midwife license.

(5) Collaboration--The process in which a midwife and a physician or another licensed health care professional of a different profession jointly manage the care of a woman or newborn according to a mutually agreed-upon plan of care.

(6) Commission--The Texas Commission of Licensing and Regulation.

(7) Compensation--Direct or indirect payment of anything of monetary value, except payment or reimbursement of reasonable, necessary, and actual travel and related expenses.

(8) Consultation--The process by which a midwife, who maintains responsibility for the woman's care, seeks the advice of a physician or another licensed health care professional or member of the health care team of a different profession.

(9) CPR certification--Official documentation of successful completion of a course in cardiopulmonary resuscitation issued by:

(A) the American Heart Association, for health care providers;

(B) the Red Cross, for the professional rescuer;

(C) the National Safety Council, for healthcare providers and the professional rescuer; or

(D) any other provider of a CPR course for health care providers currently accepted by the Department of State Health Services' Office of EMS/Trauma Systems Coordination.

(10) Department--The Texas Department of Licensing and Regulation.

(11) Direct supervision--Real-time, in-person observation and guidance by a preceptor who is physically present and immediately available to provide any necessary assistance and personally respond to any emergency.

(12) Executive director--The executive director of the department.

(13) Health authority--A physician who administers state and local laws regulating public health under the Health and Safety Code, Chapter 121, Subchapter B.

(14) Local health unit--A division of a municipality or county government that provides limited public health services as provided by the Health and Safety Code, §121.004.

(15) MANA--The Midwives Alliance of North America.

(16) MEAC--The Midwifery Education Accreditation Council.

(17) NARM--The North American Registry of Midwives.

(18) Newborn care--The care of a child for the first six weeks of the child's life.

(19) Normal childbirth--The labor and vaginal delivery at or close to term (37 up to 42 weeks) of a pregnant woman whose assessment reveals no abnormality or signs or symptoms of complications.

(20) Physician--A physician licensed to practice medicine in Texas by the Texas Medical Board.

(21) Postpartum care--The care of a woman for the first six weeks after the woman has given birth.

(22) Preceptor--an individual who provides direct supervision of a student and is:

(A) a midwife licensed in Texas;

(B) a certified nurse-midwife, as defined in the Act; or

(C) a physician licensed in Texas and actively engaged in the practice of obstetrics in an out-of-hospital setting.

(23) Public health district--A district created under the Health and Safety Code, Chapter 121, Subchapter E.

(24) Referral--The process by which a midwife directs the client to a physician or another licensed health care professional who has current obstetric or pediatric knowledge and who is working under supervision and delegation of a physician.

(25) Retired midwife--A person holding a retired voluntary charity care status license under §115.16.

(26) Standing delegation orders--Written instructions, orders, rules, regulations or procedures prepared by a physician and designated for a patient population, and delineating under what set of conditions and circumstances actions should be instituted, as described in the rules of the Texas Medical Board in 22 Texas Administrative Code, Chapter 193 (relating to Standing Delegation Orders).

(27) Student--A person performing activities under a basic midwifery education course or a preceptorship to fulfill the requirements for a midwife license or certification by NARM.

(28) Transfer--The process by which a midwife relinquishes care of the client for pregnancy, labor, delivery, or postpartum care or care of the newborn to a physician or another licensed health care professional who has current obstetric or pediatric knowledge and who is working under the supervision and delegation of a physician.

(29) Voluntary charity care--Midwifery care provided without compensation and with no expectation of compensation.

Source Note: The provisions of this §115.1 adopted to be effective October 1, 2016, 41 TexReg 4477; amended to be effective May 1, 2019, 44 TexReg 1849; amended to be effective September 1, 2023, 48 TexReg 4660