| 16 May 2017 | GOVERNMENT GAZETTE, WA | 2489 |
HEALTH
HE301
Health (Miscellaneous Provisions) Act 1911
Health (Notifications by Midwives) Amendment
Regulations 2017
Made by the Governor in Executive Council.
I. Citation
These regulations are the Health (Notifications by Midwives)
Amendment Regulations 2017. |
2. Commencement
These regulations come into operation as follows —
| (a) | regulations 1 and 2— on the day on which these regulations are published in the Gazette; |
| (b) | the rest of the regulations — on 1 July 2017. |
3. Regulations amended
These regulations amend the Health (Notifications by Midwives)
| 2490 | GOVERNMENT GAZETTE, WA | 16 May 2017 |
4. Schedule amended
In the Schedule delete Form 2 and insert:
Form 2
[r. 4]
| 80 ItnotlIcatlons Dy IO8OWIVOSJ it.guiations a | oem £ | tA3C Al ILIWLU - | rIILUIOA00.T tJ I AILS IVllL |
)llIIt.AIItAD
| Last name | umtp.mrdNo | I 11i_LLL! I Catab | crrii_i Ward |
| Add.- of ow | residence | Ua,*al status
Intun!nnlam.d 2.Wdaned 3-dnm.d |
| Numb., and nt,..t | __________ | ________ Post code | J | J | J | £.wpa,.l.d | an,Ind (ori. DfaltoI |
| Town or suburb | KIWO | Ethnic status of mother |
| Maldnnatne | (whob on) | e | 100. | . | , | ts |
| IntepneteMce,qured(Iyts?ma | Te4n88080 | I | 111t1 mt 0boen | 22 AbottO.i and 121 |
| Mth.?slaaguaço | qlro | b.istue | or Other, |
| PLOMItCY D(TAIIS | V.c,inattons daring neeInwtyn |
| P*tVIOUSP*!GNANCI(S | 22 | Vmo,rgi'2thmt00 | loflonnta | Pntacsh |
| Total numb" (e,cIad, this peenancy), | w v.ccowemtdeoo,roww.ow | - | I |
| p.wcu(excluding IMs pregnancy): | 03 | tuncilIadd.ON.f nntWSlne |
| Pnittotat pe.gn.ncyoutcaman: | Og | | 14s0tu | .doI..nkoO00. b.nhlftr, | |
99 lhnb,O,o, I ancmated
Irborn, now dead
| I | fr,18t | atrnrnt, Inclode | t) |
Numb, of gegniOunc..tIrmot
2 Ceew*C1l Sable
| Ceenirean last d.lvsny | 1.9w | 2-o | - | CVT/PIaCentJt bopsy |
| P'en.os,s r,,uIIIpIe births | 1-re, | 2-,o |
| THIS PREGNANCY: | S | U1,.atand |
| Ftin,atod gest .bat Ic | anInnatal of dl | 6 | CTG anlnPattuIn |
Total t,on,bcn of antenatal Ca,. 08th
| of IMP: | lntund,d place of 661*1 at onset of labotrn: |
| Thhdate certain | I | prs | 2.no | t4m.Sj ).*cn,.arxPcatoPon'a |
| I | I31Q1 | I | 1 | lVIInrt.n 0 | IcO. | d.tO.. n -I. |
| Expected due dat. | I | I | I |
| Based an | l..*no.f.,ildmet | El oc.soar: | - |
-
324rmosnd2Qw*c
| - | Principal rector for klductiol, of labour rfna, |
Number Of tobacco canttm uwallynmobod
LLi-
| each day dtaVtf fret 20 w.skt of pregnancy | Augmentation (labour has beytar); |
| Numberof tobacco car.tten usually nmt*ad | 1 9900 |
| |
| each day after 20 weeks of pregnancy |
| I 'm. | 08 | . O00050.dI | tI,tMedn I ow | 3 | prottagIandot |
4 - amhcal nIptosy of nseenb.ane.
| Alcohol duckig PVrCY | 8 | 0th., |
| feqaencyef dnnkctg an alcoholic dnnk |
| 3I.w. | Iuctton (before loboorbeqon)I |
| 22.1.0.01, | .0' drra,n on,,. ontO | I rca |
| 33.2101t.,......Mh | ••.&$4 |
| 2 |
| Numb., of standard akohol dr.*.s on a typuil day | DT | I | tItOSI33ttItd99 |
| Was scroseeft for d.pr.ufot.ukty comdect.d | - |
4 - artificial rupture of nleyb,ones
| -m | 2-not offered 3- dnsikled 8- ,a1000n | S | dlalationdenlceIe FtbyCathetnn |
Was additional folloon,p Indicated foe pnnkr.lcl
mental 10218*1 -AfaUo,sf
| I 90S 2.00 | 7 • 001 apfOcabl. | 8. onklown |
| Complications of pnsgn.rco | Ara.sla (thump iobOue)8 |
| I - II.ealcnnd abortion (120am) | 2 Ltnuowoxide |
| 2 - Ikinaklnod prtwrt lab.., (037at.l | 4 - todotid(caudal |
| 3 | stmaay (lcd .,fect,on | 5 _tt1'I'ri |
| 4 | pe.-.dlnIia | |
| S | attapartom ha,00e,t,ag. (APeI) ptac1000 poa.n.a | 7 | orrthki.d ,pfr.al/tyE&lcl |
| *1 | *281 -plaeencalabnptfon | 8 | abhor |
| 1 | *281-other | OucOtlor of labour |
| 8 | pee-labooroçnatn Of nwo,,bnne. | slafe (hoa, | P olIn): |
| 'I | pratallonof debate. |
| It gesfall000lttyprrbenslon | 22 58220 (Pro., | P non): |
| 1? | pIe ftlannp%la wp..angowd an escentlal )rpn.lenslon | Postnatal blood losn In mt.: |
| 99 | sprody)_______________________ | 9.11,10,0' hoboes born adrn.n 85,80015 OnfylI |
Imto00al
18amtnn.a
| S | type ldiabetes |
| t | Iype2dIabete. |
8 oth.t(tpacdg)_______________________
| 16 May 2017 | GOVERNMENT GAZETTE, WA | 2491 |
| SflI OETAAS | Bonn before anr$rall | juprs 2am |
| AnaesthesIa (thating drstsery)' | U |
Birth 4mm (24&Ooc*)
2 local anaesthesia to perineum
| 3 | | podendal | Ph.ruliry. (nrcmbe,cbebiiu | this bath) | [] | |
| 4 | | epidural/casdal | Birth ordain. (tpecey this baby, eq. 1=1" baby bon 2=2) | [] | |
| S | |
El
| 6 | general | lne'Tec 2-breeds 3-face 4beow 8othee |
| 7 | combined sgcnaVrpd,cral | |
| 8 | other | Method of birth: |
| CompIkaticrss of INbour and birth | o | sprtaneoos |
| (virbo, the ,easac,Jbr u,nrrunng deloe,YIi | 2 | cocoons sixcesslid |
| I | precitdtalednlieerp | 3 | - | vacuum unsuccessful |
| 2 | fetal distress | 4 | forceps successful |
| 3 | peolapsed cord | 5 | forceps unsuccessful |
| 4 | cord tight around neck | 6 | breech (iropifloi) |
| S | ceplsalopelnic disproportion | 7 | electIve caesarean |
| 7 | retained placenta - | nsatBial removal |
8 persistent occipco posterior
| 9 | | shoulder dystocia | Accoo&esmnfs) | |
| 10 | | failure to progress no 3cm | I - obstetrician | |
| Il | | failure to progress S Ian | 2 | oifmer medical officer | |
| 12 | | peos.ous tenures. section | 3 midwife | |
| 13 | other(specc(y)_____________________ | 4 Hstodevt |
| Priwipol reason foe Ceesureun Section: (roB one iron onfjc) | 8 other |
| fetal comproerse | Gendeer. | immale | 2' female 3mi,deterntinate |
| 2 _scnpected fetal snecrosont.o | Status of baby at birth Iolsnebonn 2os1:llbOnn (unspecified) |
| 3 | malpresentatioct | 3.aetepartan, stillborn 4rintrapaetons stillborn |
| 4 | lackof progress n3cm |
| Indent weht(wdmolegean,) | - - - | |
| S | lack of progress in theist stage, 4cm to | 10cm |
L.ogth:(adtofecan)
6 lack of progress in the 2nd stage
| 7 _placeetapea.ssa | Head clectioferencer (evBOIe cm) |
| 8 | placental abrspt.on | Ti,,. to establish unassisted regolar breathing: (iaflofe come) |
| 9 | nasa peoesi.a | Oess.cltaolon: (Record one nAry - 5mm now. inmenmhe ei9ilearm.nb.r) |
| ioantepartam/,ntrapartsm Ituennoerhage | I none |
| 11 | multiple pregnancy | 2 _soct6n only |
| 12 | unsuccessful attempt at assisted delivery | |
| 13ur,successfu1 induction | 4 | cormtinuomai positive airway press.,,, (CPAP) |
| 14_cor4 prolapse | S | bag and mask (IPPV) |
| iSp(tsrutus caesarean section | 6 | endostecheal metabation |
| 36 | persons sholderdystocia | 1 | ens. ca.ac massage and eentmlat.orm |
| ilpewsrotcs penned Uotcmu/4° | degree tear | Other |
| lBprewotcs adverse letal/neonatal outcome | Apgar score: | imirnule | LII |
19 other obstetric, medical, surgical, psychological
| |
| 20 | | maternal choice In the absence of annyobstwtnc, | Estimated gestation: (allele ereede) | . | |
| inepical, surgical, psychological indications | Birth drIents (pen4y) | |
| petrinital sSaciac | Birth trauma: Isoecthm) |
| I | intact | BABY SEPARATION D6TAILS |
| 2 | 1" degree tree/vaginal tear |
| Separation date: |
| 3 7e | degree tear | _L..iJLLJ |
Mode of separation:
| 5 | episcotomy | l-measslenre3 | Bedied 9stschargrd home |
| B '0then | I T'°oevee tear | Transferred tee (:pecd'y enlobhsh.'m,ent cc*) | 1] [11 |
| Special core noember of days: |
| (&ckdru Level I; ss.I,o.le lAmps only) |
ABORIGIkAI, STATUS Of BABY (Tick ore boc only)
| Aborisinal but not Tories Strait Islander | home |
| 7 | Turret Strati Islander but not Aboriginal | Dare | I I I I 111 01 I |
3 _Aboriginal and Tomes Strait Islander
4 other
| R. NEILSON, Clerk of the Executive Council. |