Section R9-16-101. Definitions

In addition to the definitions in A.R.S. § 36-751, the following defi- nitions apply in this Article unless otherwise specified:

1.        “Abnormal presentation” means the fetus is not in a head- down position with the crown of the head being the lead- ing body part.

2.        “Addiction” means a condition that results when a person ingests a substance that becomes compulsive and inter- feres with ordinary life responsibilities, such as work, relationships, or health.

3.        “Amniotic” means the fluid surrounding the fetus while in the mother's uterus.

4.        “Apgar score” means the number indicating a newborn’s physical condition attained by rating selected body func- tions.

5.        “Aseptic” means free of germs.

6.        “Breech” means a complete breech, a frank breech, or an incomplete breech.

7.        “Certified nurse midwife” means an individual who meets the criteria in 4 A.A.C. 19, Article 5 and is certified by the Arizona State Board of Nursing.

8.        “Complete breech” means that at the time of birth the but- tocks of a fetus is pointing downward with both legs folded at the knees and the feet near the buttocks.

9.        “Calendar day” means each day, not including the day of the act, event, or default from which a designated period of time begins to run, but including the last day of the period unless it is a Saturday, Sunday, statewide furlough day, or legal holiday, in which case the period runs until the end of the next day that is not a Saturday, Sunday, statewide furlough day, or legal holiday.

10.     “Cervix” means the narrow lower end of the uterus which protrudes into the cavity of the vagina.

11.     “Consultation” means communication between a midwife and a physician or a midwife and a certified nurse mid- wife for the purpose of receiving a written or verbal rec- ommendation and implementing prospective advice regarding the care of a pregnant woman or the woman’s child.

12.     “Current photograph” means an image of an individual, taken no more than 60 calendar days before the submis- sion of the individual's application, in a Department- approved electronic format capable of producing an image that:

a.         Has a resolution of at least 600 x 600 pixels but not more than 1200 x 1200 pixels;

b.        Is 2 inches by 2 inches in size;

c.         Is in natural color;

d.        Is a front view of the individual's full face, without a hat or headgear that obscures the hair or hairline;

e.         Has a plain white or off-white background; and

f.         Has between 1 and 1 3/8 inches from the bottom of the chin to the top of the head.

13.     “Dilation” means opening of the cervix during the mech- anism of labor to allow for passage of the fetus.

14.     “Effacement” means the gradual thinning of the cervix during the mechanism of labor and indicates progress in labor.

15.     “Emergency care plan” means the arrangements estab- lished by a midwife for a client’s transfer of care in a situ- ation in which the health or safety of the client or newborn are determined to be at risk.

16.     “Emergency medical services provider” has the same meaning as in A.R.S. § 36-2201.

17.     “Episiotomy” means the cutting of the perineum, center, middle, or midline, in order to enlarge the vaginal open- ing for delivery.

18.     “Fetus” means a child in utero from conception to birth.

19.     “Frank breech” means that at the time of birth the but- tocks of a fetus is pointing downward with both legs folded flat up against the head.

20.     “Gestation” means the length of time from conception to birth, as calculated from the first day of the last normal menstrual period.

21.     “Gravida” means the number of times the mother has been pregnant, including a current pregnancy, regardless of whether these pregnancies were carried to term.

22.     “Incomplete breech” means that at the time of birth the buttocks of a fetus is pointing downward with one leg folded at the knee with the foot near the buttocks.

23.     “Infant” has the same meaning as in A.R.S. § 36-694.

24.     “Informed consent” means a document signed by a client, as provided in R9-16-109, agreeing to the provision of midwifery services.

25.     “Intrapartum” means occurring from the onset of labor until after the delivery of the placenta.

26.     “Jurisprudence test” means an assessment of an individ- ual’s knowledge of the:

a.         Laws of this state concerning the reporting of births, prenatal blood tests, and newborn screening; and

b.        Rules pertaining to the practice of midwifery.

27.     “Ketones” means certain harmful chemical elements which are present in the body in excessive amounts when there is a compromised bodily function.

28.     “Local registrar” means a person appointed by the state's registrar of vital statistics for a registration district whose duty includes receipt of birth and death certificates for births and deaths occurring within that district for review, registration, and transmittal to the state office of vital records according to A.R.S. Title 36, Chapter 3.

29.     “Meconium” means the first bowel movement of the newborn, which is greenish black in color and tarry in consistency.

30.     “Midwifery services” means health care, provided by a midwife to a mother, related to pregnancy, labor, delivery or postpartum care.

31.     “Newborn” has the same meaning as in A.R.S. § 36-694.

32.     “Para” means the number of births that are greater than 20 weeks of gestation, including viable and non-viable births, where multiples are counted as one birth.

33.     “Parity” means the number of newborns a woman has delivered.

34.     “Perineum” means the muscular region in the female between the vaginal opening and the anus.

35.     “Physician” means an allopathic, an osteopathic, or a naturopathic practitioner licensed according to A.R.S. Title 32, Chapters 13, 14, or 17.

36.     “Postpartum” means the six-week period following deliv- ery of a newborn and placenta.

37.     “Prenatal” means the period from conception to the onset of labor and birth.

38.     “Prenatal care” means the on-going risk assessments, clinical examinations, and prenatal, nutritional, and antic- ipatory guidance offered to a pregnant woman.

39.     “Prenatal visit” means each clinical examination of a pregnant woman for the purpose of monitoring the course of gestation and the overall health of the woman.

40.     “Primigravida” means a woman who is pregnant for the first time.

41.     “Primipara” means a woman who has given birth to her first newborn.

42.     “Quickening” means the first perceptible movement of the fetus in the uterus, occurring usually in the 16th to the 20th week of gestation.

43.     “Rh” means a blood antigen.

44.     “Serious mental illness” means a condition in an individ- ual who is 18 years of age or older and who exhibits emo- tional or behavioral functioning, as a result of a mental disorder as defined in A.R.S. § 36-501, that:

a.         Is severe and persistent, resulting in a long-term lim- itation of their functional capacities for primary activities of daily living such as interpersonal rela- tionships, homemaking, self-care, employment and recreation; and

b.        Impairs or substantially interferes with the capacity of the individual to remain in the community with- out supportive treatment or services of a long-term or indefinite duration.

45.     “Substance abuse” means the continued use of alcohol or other drugs in spite of negative consequences.

46.     “Shoulder dystocia” means the shoulders of the fetus are wedged in the mother's pelvis in such a way that the fetus is unable to be born without emergency action.

47.     “Transfer of care” means that a midwife refers the care of a client or newborn to an emergency medical services provider, a certified nurse midwife, a hospital, or a physi- cian who then assumes responsibility for the direct care of the client or newborn.

48.     “Working day” means a Monday, Tuesday, Wednesday, Thursday, or Friday that is not a state holiday or a state- wide furlough day.

Historical Note

Section repealed, new Section adopted effective March 14, 1994 (Supp. 94-1). Section amended by exempt

rulemaking at 19 A.A.R. 1805, effective July 1, 2013

(Supp. 13-2).