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(l) The birth center shall develop written practice protocols that reflect how the birth center will implement applicable standards of practice. The birth center shall ensure that the governing body approves the practice protocols. The practice protocols must

(1) include a comprehensive, step-by-step guide to care that addresses specific conditions that are expected or that may arise during prenatal care, delivery, or postpartum care; and

(2) be designed to ensure and enhance safe, high-quality care. (m) Surgical procedures provided in a birth center must be limited to those normally performed during and after uncomplicated childbirth, and must be performed in accordance with the practice protocols developed under ( l) of this section. A surgical procedure that includes operative obstetrics or a cesarean section may not be performed in a birth center. (n) General or conduction anesthesia may not be administered in a birth center. Local anesthesia may be administered, and an episiotomy and episiotomy or laceration repair may be provided, if performed by a midwife in accordance with that midwife’s applicable scope of practice as required under (b) of this section. The birth center shall establish and implement policies and procedures that address the administration of local anesthesia, the provision of episiotomies, and episiotomy or laceration repair. (o) Labor may not be induced, stimulated, or augmented with oxytocin or any other pharmacological agent. If there is fetal distress or a prolapsed cord, the birth center may use a pharmacological agent to inhibit labor while making arrangements to transport the client to a hospital. (p) A birth center may not use vacuum extractors, forceps, or ultrasound imaging in the birth center. Except as provided in 7 AAC 12.430(a)(3)(G), a birth center may not use recorded electronic fetal monitors in the birth center. (q) Each client and newborn must be discharged, or transferred if necessary, within 24 hours after the newborn’s birth. If a longer stay becomes necessary for a client or newborn, the birth center must

(1) document in the medical record that the client and newborn were expected, at the time of admission, to be discharged within 24 hours after the newborn’s birth; and

(2) describe in the report required under 7 AAC 12.405(j)(10) the reason for any stay beyond 24 hours after the newborn’s birth. (Eff. 11/19/83, Register 88; am 9/30/2007, Register 183) Statutory Authority: Authority: AS 47.32.010 AS 47.32.030