Section 630.30 Health Services for Women of Reproductive Age

Section 630

Section 630.30  Health

Services for Women of Reproductive Age

The Division of Family Health,

Department of Public Health, State of Illinois, through its Maternal and Child

Health Program may allocate funds for programs providing health services for

women of reproductive age. All such services must be delivered based upon the

standards of the American Congress of Obstetricians and Gynecologists set forth

in Section 630.80(a)(5), Family Planning Services Code (77 Ill. Adm. Code

635.90), Regionalized Perinatal Health Care Code (77 Ill. Adm. Code 640), and

Hospital Licensing Requirements (77 Ill. Adm. Code 250.1810-1860) (See Section

630.80(a)(5)). One or more of the following MCH services may be included in

application proposals for Title V and State MCH Project grant funds:

a)         Services for nonpregnant women that relate to the occurrence

and course of future pregnancy.

1)         Comprehensive family planning services as described in the

Department's Family Planning Services Code − 77 Ill. Adm. Code 635.90.

2)         Genetic evaluation counseling as indicated.

3)         Counseling and referral to licensed adoption services if

indicated or desired.

b)         Services for pregnant woman.

1)         Early diagnosis of pregnancy.

2)         Counseling regarding plans for pregnancy continuation.

A)        For those electing to carry to term, referral for and provision

of prenatal care.  Referral to childbirth preparation classes as desired or to

adoption services at licensed agencies if indicated.

B)        For those electing abortion, referral to appropriate counseling

and family planning facilities.

3)         Prenatal care services including:

A)        History (general medical-surgical, social and occupational,

family and genetic background, health habits, previous pregnancies, and current

pregnancy).

B)        Complete physical examination including blood pressure, height

and weight, and fetal development as well as a complete systems review

te counseling

and family planning facilities.

3)         Prenatal care services including:

A)        History (general medical-surgical, social and occupational,

family and genetic background, health habits, previous pregnancies, and current

pregnancy).

B)        Complete physical examination including blood pressure, height

and weight, and fetal development as well as a complete systems review.

C)        Laboratory tests as appropriate, such as syphilis serology, Papanicolaou

smear, gonococcal culture, chlamydia smear, hepatitis B, diabetic screening,

hemoglobin/hematocrit, urinalysis for glucose and protein, Rh determination and

irregular antibody screening, blood group determination, and rubella test.

D)        Diagnosis and treatment or referral and follow-up of general

health problems, both acute and chronic, preexisting or arising during the

prenatal period, that can adversely affect pregnancy, fetal development, or

maternal health.

E)        Referral and follow-up of mental health problems, both acute

and chronic, preexisting or arising during the prenatal period, that can

adversely affect pregnancy, fetal development, or maternal health.

F)         Nutritional assessment and services as needed.  Provision of

vitamin, iron and other supplements as appropriate. The water supply for

clients on nonpublic sources should be tested for nitrates by the Illinois

Department of Public Health Laboratories.

G)        Dental services limited to oral pathology that can directly

affect the outcome of pregnancy.

H)        Subsequent prenatal visits should include at the minimum:

blood pressure, weight, urinalysis for protein and glucose, ascertaining fetal

development, update on pertinent medical history, height of fundus, rate and

location of fetal heart tones, periodic hemoglobin and/or hematocrit as well as

a vaginal examination and other special tests as indicated (e.g., Rh titer).

Visits should occur at ACOG recommended frequency

should include at the minimum:

blood pressure, weight, urinalysis for protein and glucose, ascertaining fetal

development, update on pertinent medical history, height of fundus, rate and

location of fetal heart tones, periodic hemoglobin and/or hematocrit as well as

a vaginal examination and other special tests as indicated (e.g., Rh titer).

Visits should occur at ACOG recommended frequency.

I)         Screening, diagnosis (including amniocentesis), and counseling

with follow-up for selected fetal genetic defects.

J)         An assessment to identify high risk pregnancies and

appropriately consult and/or refer within the Perinatal System.

K)        Home health and homemaker services.

L)        Counseling and anticipatory guidance with referral and followup

as needed regarding:

i)          Physical activity and exercise.

ii)         Nutrition during pregnancy, including the importance of

adequate but not excessive weight gain.

iii)        Avoidance during pregnancy of smoking, alcohol and other

drugs; and of environmental hazards including radiation, hazardous chemicals,

and various workplace hazards.

iv)        Signs of problems arising during pregnancy and at the onset of

labor, including signs of preterm labor.

v)         Preparation of the woman (and her partner where appropriate)

for labor and delivery, including plans for place of delivery and use of

anesthesia.

vi)        Use of medication during pregnancy.

vii)       Infant nutritional needs and feeding practices, including breast

feeding.

viii)      Child care arrangements.

ix)        Parenting skills, including meeting the physical, emotional

and intellectual needs of the infant, with specific appraisal to detect parents

at risk of child abuse or neglect.

x)         Planning for continuous and comprehensive pediatric care

following delivery, including arrangements for a pediatric antenatal visit to

link the family to pediatric care

Child care arrangements.

ix)        Parenting skills, including meeting the physical, emotional

and intellectual needs of the infant, with specific appraisal to detect parents

at risk of child abuse or neglect.

x)         Planning for continuous and comprehensive pediatric care

following delivery, including arrangements for a pediatric antenatal visit to

link the family to pediatric care.

xi)        Emotional and social changes occasioned by the birth of a

child, including changes in marital and family relationships, the special needs

of the mother in the postpartum period, and preparing the home for the arrival

of the newborn.

xii)       Referral to appropriate community health resources such as

WIC, food stamps, welfare and social services that can benefit health status

significantly.

xiii)      Discussions regarding postpartum family planning options.

xiv)      Housing (including alternative placement).

xv)       Other relevant topics in response to patient concern.

4)         Services in the intrapartum period.

A)        Assessing the progress of labor and the condition of the mother

and fetus throughout labor.

B)        Medical services during labor and delivery for diagnosis and

management of conditions threatening the mother and/or infant, including the

availability of a Cesarean birth operation when indicated and consultation

and/or referral for high risk perinatal problems within the Perinatal System.

C)        Delivery and/or referral of the baby to the appropriate level

facility within the Perinatal System.

D)        RH workup and Rhogam administration as indicated.

5)         Services during the postpartum period.

A)        Diagnosis and treatment or referral and follow-up of general

health problems, both acute and chronic, preexisting or arising during the

postpartum period that can adversely affect the mother's health and/or child

caring abilities

te level

facility within the Perinatal System.

D)        RH workup and Rhogam administration as indicated.

5)         Services during the postpartum period.

A)        Diagnosis and treatment or referral and follow-up of general

health problems, both acute and chronic, preexisting or arising during the

postpartum period that can adversely affect the mother's health and/or child

caring abilities.

B)        Diagnosis and treatment or referral and follow-up of mental

health or behavioral problems, both acute and chronic, preexisting or arising

during the perinatal and postpartum periods (including maternal depression)

that can adversely affect the mother's health and/or child care abilities.

C)        Counseling and anticipatory guidance with referrals and

follow-up as needed regarding:

i)          Postpartum changes, both normal and abnormal.

ii)         Family planning methods.

iii)        Infant development and behavior.

iv)        Infant nutritional needs and feeding practices, including

breast feeding.

v)         Automobile restraints for infants and children, and general

accident prevention concepts (especially home accidents and accidental

poisoning).

vi)        Infant stimulation and parenting skills, with specific

appraisal to identify parent as risk for child abuse or neglect.

vii)       Need for and importance of immunizations.

viii)      Effect on children of parental smoking, use of alcohol and

other drugs, and other health-damaging behaviors.

ix)        The importance of a source of continuous and comprehensive

care for both mother and child, including identification of available resources

to help with such problems as illness in the newborn, breast feeding

difficulties or problems with contraception.

x)         Recognition and management of illness in the newborn.

xi)        Infant care.

xii)       Child care arrangements.

xiii)      Using community health resources such as WIC, food stamps,

welfare and social services that bear significantly on health status

available resources

to help with such problems as illness in the newborn, breast feeding

difficulties or problems with contraception.

x)         Recognition and management of illness in the newborn.

xi)        Infant care.

xii)       Child care arrangements.

xiii)      Using community health resources such as WIC, food stamps,

welfare and social services that bear significantly on health status.

xiv)      Physical activity and exercise.

xv)       Nutrition assessment and services.

xvi)      General health practices.

xvii)     Genetic diagnostic services and counseling if indicated.

xviii)    Other relevant topics in response to parental concern.

xix)      Organic medical problems such as renal and heart disease,

hypertension, diabetes, and endocrine problems.

D)        Diagnosis and treatment or referral and follow-up for general

health problems (of project registrants) that can adversely affect future

pregnancy, fetal development, and maternal health such as:

i)          Sexually transmitted diseases.

ii)         Immune status (such as rubella).

iii)        Gynecological anatomic and functional disorders.

iv)        Inadequate nutritional status, including both under and

overweight.

v)         Occupational exposures.

vi)        Acute dental problems such as infection.

vii)       Family history of genetic disorder.

E)        Comprehensive family planning services, during intrapartum and

postpartum period, including:

i)          Information, education, and counseling regarding family

planning concepts and techniques, and other issues such as the importance of

prenatal care, and risks to mother and child of childbearing at extremes of the

reproductive age span.

ii)         History and physical examination, including heart, lungs,

thyroid, breast and pelvic examination, as indicated, and tests such as a Papanicolaou

smear, gonococcal culture, chlamydia testing, hematocrit urinalysis, and

serological examination for syphilis, as appropriate

rtance of

prenatal care, and risks to mother and child of childbearing at extremes of the

reproductive age span.

ii)         History and physical examination, including heart, lungs,

thyroid, breast and pelvic examination, as indicated, and tests such as a Papanicolaou

smear, gonococcal culture, chlamydia testing, hematocrit urinalysis, and

serological examination for syphilis, as appropriate.

iii)        Provision of family planning methods and instruction

regarding their use.

iv)        Sterilization counseling, information, and education.

v)         Sterilization treatment services for persons 21 years of age

and over, and legally capable of consent.

vi)        Rubella immunization as indicated.

vii)       Genetic counseling services.

F)         Home health and homemaker services.

G)        Routine postpartum examination, four to six weeks following

delivery with referrals and follow-up as needed, including:

i)          Physical examination and intrapartum history.

ii)         Laboratory services as appropriate.

iii)        Family planning services.

iv)        Rubella immunization as indicated.

c)         Access-related services:

1)         Outreach services.

2)         Translator and 24-hour emergency telephone services.

3)         Child care services to facilitate obtaining needed health

services and other social services as needed.

4)         Availability of services directly or through referral

regardless of handicapping conditions.

5)         Transportation.