(1) Initial Visit shall include:
    (a) A comprehensive health history shall be completed which includes medical, emotional, dietary, and obstetrical data including a pre-term delivery risk assessment.
    (b) A physical examination shall be completed by a physician, or certified nurse midwife or advanced practice registered nurse, or licensed midwife, which includes measurement of height and weight, vital signs including blood pressure and examination of the skin, head and neck, heart and lungs, breasts, abdomen, pelvis and neurologic reactions.
    (c) The following tests are required:
Hemoglobin or hematocrit, urinalysis by dipstick for protein, sugar, and ketones; serological test for syphilis; cervical cytology, and Rh determination and blood type. Results of a cervical cytology done within one year is acceptable. The hemoglobin test and urinalysis may be performed by a clinical staff member or qualified personnel.
    (2) Return visits shall include:
    (a) Measurements of the weight, blood pressure, fundal height, and fetal heart rate when applicable;
    (b) Urinalysis by dipstick for protein and sugar;
    (c) Hemoglobin or hematocrit should be repeated at least twice and more often if indicated during the course of the pregnancy;
    (d) Review of signs and symptoms of complications of pregnancy and risk status; and,
    (e) Examination to determine the estimated weeks of gestation, fetal position and presentation.
    (3) Return prenatal visits shall be scheduled at least every four weeks until the 32nd week, every two weeks until the 36th week and then every week until delivery unless the client’s condition requires more frequent visits.
    (4) A prenatal delivery risk assessment shall be performed during the initial visit and repeated at 28 weeks gestation.
    (5) All clients shall receive specific instruction regarding pre-term labor including the potential hazards, preventive measures, symptoms, detection and timing of contractions, and the need for prompt notification of the health provider.
    (6) All clients found to be at high obstetrical risk pursuant to criteria described in Fl. Admin. Code R. 59A-11.009, shall be referred to a qualified physician for continued care.
Rulemaking Authority 383.309 FS. Law Implemented 383.312, 383.313 FS. History-New 3-4-85, Formerly 10D-90.12, 10D-90.012, Amended 9-27-94, 9-17-96, 2-21-17.