Section 264.1050  Definitions


Act – Birth Center Licensing Act.


Adequate – enough in either quantity or quality, as determined by a reasonable person familiar with the professional standards of the subject under review, to meet the needs of the clients of a birth center under the set of circumstances in existence at the time of review.


Administrative Perinatal Center or APC – a referral facility intended to care for the high-risk client before, during, or after labor and delivery and characterized by sophistication and availability of personnel, equipment, laboratory, transportation techniques, consultation and other support services.  An APC is a university or university-affiliated hospital designated by the Department as a Level III hospital that receives financial support from the Department to provide leadership and oversight of the Regionalized Perinatal Healthcare Program.


Administrator – the person who is directly responsible for the operation and administration of the birth center, irrespective of the person's assigned title.


Advanced practice registered nurse or APRN – a person who has met the qualifications for a certified nurse midwife (CNM); certified nurse practitioner (CNP); certified registered nurse anesthetist (CRNA); or clinical nurse specialist (CNS) and has been licensed by the Department of Financial and Professional Regulation. (Section 50-10 of the Nurse Practice Act)


Antepartum – the period before labor or childbirth.


Applicant – any person, acting individually or with any other person, who proposes to build, own, establish or operate a birth center.


Birth assistant – a licensed certified professional midwife or a person licensed or certified in Illinois by the Department of Financial and Professional Regulation in a health-related field and under the supervision of a physician, a certified nurse midwife, or a licensed certified professional midwife who in attendance, has specialized training in labor and delivery techniques and care of newborns; and receives planned and ongoing training as needed to perform assigned duties effectively. (Section 25(d) of the Act)


Birth attendant – an obstetrician, family practitioner (family physician) physician, certified nurse midwife, or licensed certified professional midwife shall attend each person in labor from the time of admission through birth and throughout the immediate postpartum period. (Section 25(c) of the Act)


Birth center or center – a designated site, other than a hospital:


in which births are planned to occur following a normal, uncomplicated, and low risk pregnancy;


that is not the pregnant person’s usual place of residence;


that is dedicated to serving the childbirth-related needs of pregnant persons and their newborns, and has no more than 10 beds;


that offers prenatal care and community education services and coordinates these services with other health care services available in the community; and


that does not provide general anesthesia or surgery (except as allowed per Sections 264.1800(h) and (i). (Section 5 of the Act)


Birthing person – an individual who is pregnant or in labor.


Birth room – a room specifically designed and equipped for a single occupancy client to give birth under the care of birth attendant.


Birth unit – several birth rooms grouped or clustered around a central area/station that maintains direct supervision (electronic supervision is not permitted) of the birth rooms.


Certified nurse midwife or CNM – an advanced practice registered nurse licensed in Illinois under the Nurse Practice Act with full practice authority or who is delegated such authority as part of a written collaborative agreement with a physician who is associated with the birthing center or who has privileges at a nearby birthing hospital.  (Section 5 of the Act)


Charitable care – the intentioned provision of free or discounted birth center services to persons who cannot afford to pay for the services.


Client – a person who receives services provided at the birth center and the infant of that birth.


Clinical director – a physician who is either certified or eligible for certification by the American College of Obstetricians and Gynecologists or the American Board of Osteopathic Obstetricians and Gynecologists or has hospital obstetrical privileges; or a certified nurse midwife (CNM) (Section 25 of the Act) who provides guidance, leadership, oversight, and quality assurance to the birth center.


Close proximity –a distance which allows a person to be physically present in a place within 30 minutes after being called.


Community education services – information and education provided to the pregnant person and their family, during both early and late pregnancy, that promote healthy outcomes for the pregnant person and their infant and postpartum period. 


Department – the Illinois Department of Public Health. (Section 5 of the Act)


Governing body – a board of trustees, governing board, board of directors or other body or individual responsible for governing a birth center.


Gravidity and Parity or GP – the number of times a person has been pregnant (gravidity) and carried the pregnancies to a viable gestational age (parity).


Health-related field – either a registered nurse, certified professional midwife or licensed practical nurse, or other classifications that are licensed, registered, or certified by the Illinois Department of Financial and Professional Regulation.


High-risk client – a person, fetus, or newborn with an increased level of risk of harm or mortality from congenital and/or environmental factors.


Hospital – a facility licensed under the Hospital Licensing Act. "Hospital" does not include places where pregnant females are received, cared for, or treated during delivery if it is in a licensed birth center, nor includes any facility required to be licensed as a birth center.  (Section 5 of the Act)


Immediate postpartum period – the first 24 hours after childbirth.  This period refers to the time just after childbirth, during which the infant's physiology adapts and the risks to the pregnant person of postpartum hemorrhage and other significant morbidity are highest.


Inspection – any survey, evaluation, or investigation of the birth center's compliance with the Act and this Part by the Department or designee.


Intrapartum – the time from the onset of labor until the delivery of the infant and placenta.


Licensed certified professional midwife – a person who has successfully met the requirements under Section 45 of the Licensed Certified Professional Midwife Practice Act and holds an active license to practice as a licensed certified professional midwife in Illinois.  (Section 5 of the Act)


Licensee – the person or entity licensed to operate the birth center.


Low-risk pregnancy – a pregnancy that, based on history, application of risk criteria per subsection 264.1550(g), and adequate prenatal care, is broadly predicted to have a normal, uncomplicated outcome.


Medical care facility – a hospital, birthing center, and any other licensed facility that provides obstetrical and newborn nursery services. (Section 2 of the Early Hearing Detection and Intervention Act)


Newborn infant or newborn or infant – an infant who is delivered at the birth center or a referral hospital following transfer from the birth center.


Nurse – a registered nurse or licensed practical nurse as defined in the Nurse Practice Act.


Obstetrician – a physician who is certified or eligible for certification by the American Board of Obstetricians and Gynecologists.


Operator – the person responsible for the control, maintenance and governance of the birth center, its personnel and physical plant.


Owner – the individual, partnership, corporation, or other person who owns the birth center.


Physician – a physician licensed to practice medicine in all its branches in Illinois.  (Section 5 of the Act)


Postpartum person – an individual who gave birth at the birth center or who was transferred to a referral hospital.


Pregnant person – an individual with a developing embryo, fetus, or unborn child within their body.


Prenatal care – medical care for a pregnant person and their fetus throughout their pregnancy.


Program narrative – a description of the center's proposed operation, which clarifies or explains choices related to space, equipment, finishes, or other specifications in the architectural plans (See Section 264.2700). 


Quality assurance – an ongoing, objective, and systematic process of monitoring, evaluating, and improving the quality, appropriateness, and effectiveness of care.


Quality Assessment and Performance Improvement Program or QAPI – a systematic, comprehensive, and data-driven approach to maintaining and improving safety and quality in birth center services while involving all staff in practical and creative problem solving.  Quality assessment is the specification of standards for quality of service and outcomes, and is a process used throughout the organization to ensure care is maintained at acceptable levels in relation to those standards.  Performance improvement is the continuous study and improvement of processes with the intent to better services or outcomes, and to decrease the likelihood of problems, by identifying areas of opportunity.


Referral hospital – a hospital designated under the Regionalized Perinatal Health Care Code and intended to care for the high-risk client before, during, or after labor and delivery and characterized by sophistication and availability of personnel, equipment, laboratory, transportation techniques, consultation, and other support services.


Registered professional nurse or RN – a person who is licensed as a registered professional nurse under the Nurse Practice Act.


Risk assessment – a process by which historical, physical, and laboratory data are applied for the prediction of pregnancy outcome.


Sanitize – to destroy microorganisms by cleaning or disinfecting.


Sterilization – the use of a physical or chemical procedure to destroy all microbial life, including bacterial endospores.


Substantial compliance or substantially comply – meeting requirements, except for variance from the strict and literal performance that results in unimportant omissions or defects, given the circumstances involved. 


Supervision – authoritative procedural guidance by a qualified person for the accomplishment of a function or activity within his/her sphere of competence, with initial direction and periodic surveillance of the actual act of accomplishing the function or activity.


Support person – an individual who provides emotional support or help with relaxation techniques and comfort measures.


Survey – a detailed, complete inspection of the birth center.


Universal/standard precautions – as defined by the Centers for Disease Control and Prevention (CDC), recommendations designed to prevent transmission of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and other blood borne pathogens when providing health care.


Vaginal delivery – a vaginal birth that occurs without assistance from forceps or a suction device.