Illinois Compiled Statutes 225 ILCS 64/75 – Consultation and referral
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(a) A licensed certified professional midwife shall consult with a licensed physician or a certified nurse midwife providing obstetrical care whenever there are significant deviations, including abnormal laboratory results, relative to a client’s pregnancy or to a neonate. If a referral to a physician or certified nurse midwife is needed, the licensed certified professional midwife shall refer the client to a physician or certified nurse midwife and, if possible, remain in consultation with the physician until resolution of the concern. Consultation does not preclude the possibility of an out-of-hospital birth. It is appropriate for the licensed certified professional midwife to maintain care of the client to the greatest degree possible, in accordance with the client’s wishes, during the pregnancy and, if possible, during labor, birth, and the postpartum period.
(b) A licensed certified professional midwife shall consult with a licensed physician or a certified nurse midwife with regard to any childbearing individual who presents with or develops the following risk factors or presents with or develops other risk factors that, in the judgment of the licensed certified professional midwife, warrant consultation:
(1) Antepartum:
(A) pregnancy induced hypertension, as evidenced
(b) A licensed certified professional midwife shall consult with a licensed physician or a certified nurse midwife with regard to any childbearing individual who presents with or develops the following risk factors or presents with or develops other risk factors that, in the judgment of the licensed certified professional midwife, warrant consultation:
Terms Used In Illinois Compiled Statutes 225 ILCS 64/75
- Baseline: Projection of the receipts, outlays, and other budget amounts that would ensue in the future without any change in existing policy. Baseline projections are used to gauge the extent to which proposed legislation, if enacted into law, would alter current spending and revenue levels.
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- individual: shall include every infant member of the species homo sapiens who is born alive at any stage of development. See Illinois Compiled Statutes 5 ILCS 70/1.36
(1) Antepartum:
(A) pregnancy induced hypertension, as evidenced
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by a blood pressure of 140/90 on 2 occasions greater than 6 hours apart;
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(B) persistent, severe headaches, epigastric
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pain, or visual disturbances;
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(C) persistent symptoms of urinary tract
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infection;
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(D) significant vaginal bleeding before the onset
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of labor not associated with uncomplicated spontaneous abortion;
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(E) rupture of membranes prior to the 37th week
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gestation;
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(F) noted abnormal decrease in or cessation of
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fetal movement;
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(G) anemia resistant to supplemental therapy;
(H) fever of 102 degrees Fahrenheit or 39 degrees
(H) fever of 102 degrees Fahrenheit or 39 degrees
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Celsius or greater for more than 24 hours;
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(I) non-vertex presentation after 38 weeks
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gestation;
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(J) hyperemesis or significant dehydration;
(K) isoimmunization, Rh-negative sensitized,
(K) isoimmunization, Rh-negative sensitized,
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positive titers, or any other positive antibody titer, which may have a detrimental effect on the childbearing individual or fetus;
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(L) elevated blood glucose levels unresponsive to
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dietary management;
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(M) positive HIV antibody test;
(N) primary genital herpes infection in pregnancy;
(O) symptoms of malnutrition or anorexia or
(N) primary genital herpes infection in pregnancy;
(O) symptoms of malnutrition or anorexia or
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protracted weight loss or failure to gain weight;
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(P) suspected deep vein thrombosis;
(Q) documented placental anomaly or previa;
(R) documented low-lying placenta in a
(Q) documented placental anomaly or previa;
(R) documented low-lying placenta in a
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childbearing individual with history of previous cesarean delivery;
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(S) labor prior to the 37th week of gestation;
(T) history of prior uterine incision;
(U) lie other than vertex at term;
(V) multiple gestation;
(W) known fetal anomalies that may be affected by
(T) history of prior uterine incision;
(U) lie other than vertex at term;
(V) multiple gestation;
(W) known fetal anomalies that may be affected by
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the site of birth;
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(X) marked abnormal fetal heart tones;
(Y) abnormal non-stress test or abnormal
(Y) abnormal non-stress test or abnormal
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biophysical profile;
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(Z) marked or severe polyhydramnios or
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oligohydramnios;
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(AA) evidence of intrauterine growth restriction;
(BB) significant abnormal ultrasound findings; or
(CC) gestation beyond 42 weeks by reliable
(BB) significant abnormal ultrasound findings; or
(CC) gestation beyond 42 weeks by reliable
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confirmed dates;
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(2) Intrapartum:
(A) rise in blood pressure above baseline, more
(A) rise in blood pressure above baseline, more
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than 30/15 points or greater than 140/90;
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(B) persistent, severe headaches, epigastric pain
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or visual disturbances;
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(C) significant proteinuria or ketonuria;
(D) fever over 100.6 degrees Fahrenheit or 38
(D) fever over 100.6 degrees Fahrenheit or 38
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degrees Celsius in absence of environmental factors;
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(E) ruptured membranes without onset of
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established labor after 18 hours;
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(F) significant bleeding prior to delivery or any
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abnormal bleeding, with or without abdominal pain or evidence of placental abruption;
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(G) lie not compatible with spontaneous vaginal
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delivery or unstable fetal lie;
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(H) failure to progress after 5 hours of active
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labor or following 2 hours of active second stage labor;
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(I) signs or symptoms of maternal infection;
(J) active genital herpes at onset of labor;
(K) fetal heart tones with non-reassuring
(J) active genital herpes at onset of labor;
(K) fetal heart tones with non-reassuring
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patterns;
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(L) signs or symptoms of fetal distress;
(M) thick meconium or frank bleeding with birth
(M) thick meconium or frank bleeding with birth
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not imminent; or
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(N) client or licensed certified professional
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midwife desires physician consultation or transfer;
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(3) Postpartum:
(A) failure to void within 6 hours of birth;
(B) signs or symptoms of maternal shock;
(C) fever of 102 degrees Fahrenheit or 39 degrees
(A) failure to void within 6 hours of birth;
(B) signs or symptoms of maternal shock;
(C) fever of 102 degrees Fahrenheit or 39 degrees
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Celsius and unresponsive to therapy for 12 hours;
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(D) abnormal lochia or signs or symptoms of
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uterine sepsis;
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(E) suspected deep vein thrombosis; or
(F) signs of clinically significant depression.
(c) A licensed certified professional midwife shall consult with a licensed physician or certified nurse midwife with regard to any neonate who is born with or develops the following risk factors:
(1) Apgar score of 6 or less at 5 minutes without
(F) signs of clinically significant depression.
(c) A licensed certified professional midwife shall consult with a licensed physician or certified nurse midwife with regard to any neonate who is born with or develops the following risk factors:
(1) Apgar score of 6 or less at 5 minutes without
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significant improvement by 10 minutes;
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(2) persistent grunting respirations or retractions;
(3) persistent cardiac irregularities;
(4) persistent central cyanosis or pallor;
(5) persistent lethargy or poor muscle tone;
(6) abnormal cry;
(7) birth weight less than 2,300 grams;
(8) jitteriness or seizures;
(9) jaundice occurring before 24 hours or outside of
(3) persistent cardiac irregularities;
(4) persistent central cyanosis or pallor;
(5) persistent lethargy or poor muscle tone;
(6) abnormal cry;
(7) birth weight less than 2,300 grams;
(8) jitteriness or seizures;
(9) jaundice occurring before 24 hours or outside of
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normal range;
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(10) failure to urinate within 24 hours of birth;
(11) failure to pass meconium within 48 hours of
(11) failure to pass meconium within 48 hours of
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birth;
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(12) edema;
(13) prolonged temperature instability;
(14) significant signs or symptoms of infection;
(15) significant clinical evidence of glycemic
(13) prolonged temperature instability;
(14) significant signs or symptoms of infection;
(15) significant clinical evidence of glycemic
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instability;
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(16) abnormal, bulging, or depressed fontanel;
(17) significant clinical evidence of prematurity;
(18) medically significant congenital anomalies;
(19) significant or suspected birth injury;
(20) persistent inability to suck;
(21) diminished consciousness;
(22) clinically significant abnormalities in vital
(17) significant clinical evidence of prematurity;
(18) medically significant congenital anomalies;
(19) significant or suspected birth injury;
(20) persistent inability to suck;
(21) diminished consciousness;
(22) clinically significant abnormalities in vital
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signs, muscle tone, or behavior;
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(23) clinically significant color abnormality,
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cyanotic, or pale or abnormal perfusion;
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(24) abdominal distension or projectile vomiting; or
(25) signs of clinically significant dehydration or
(25) signs of clinically significant dehydration or
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failure to thrive.
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(d) Consultation with a health care professional does not establish a formal relationship with the client. Consultation does not establish a formal relationship between a licensed certified professional midwife and another health care professional.