Guideline for Universal Precautions &

OSHA Compliance

Midwives are responsible for following OSHA compliance to reduce the risk of contamination to
client or care-provider, particularly in the handling of blood-borne pathogens and body-fluids.
Hygiene of Care-Provider
Hair must be pulled back at all times.
Nails and cuticles must be trimmed short. No use of gel nail polish or artificial/acrylic
nails.
In case of risk to patient from coughing/sneezing or other airborne pathogen, mask must
be worn when providing care if sickness is assumed.
Handwashing
Handwashing facilities must be made available to all employees. The facility must include
running water, soap and single use towels or air-drying machine. Antiseptic hand sanitizer must
be made available in conjunction with paper towels or antiseptic single-use towelettes.
When handwashing, warm/hot water is preferred with lathering of hands for at least 15 seconds.
Special care must be taken to clean under the nails. Allow water to run down to the wrist turning
faucet off with elbow or forearm and dry with air-dryer or single use towelette.
Hands must be washed before and after contact with a client.
Handling and disposal of sharps:
Definition of sharps- any contaminated object that can penetrate the skin including, but not
limited to, needles, scalpels, broken glass, broken capillary tubes, and exposed ends of dental
wires. (OSHA, 2012)
Contaminated needles should not be recapped, bent, or sheathed. All needles must be disposed
of in a designated Sharps Container:
The container must be:
Labeled or color-coded,
Leakproof and puncture-proof on the sides and bottom.
Maintained upright throughout use; and
Replaced routinely and not be allowed to overfill
Personal Protective Equipment (PPE):
Equipment or garment worn for protection against a hazard. These may include gloves, eye-
protection, coverings to wear on top of clothes, booties, mask, and hair-covering.
Personal Protective Equipment is worn wherever there is a potential for exposure to a pathogen
whether airborne or body-fluid/product. This includes blood, urine, bodily secretions
(vaginal/rectal), breastmilk and saliva.
Gloves: Gloves must be donned before exposure to any of the afore-mentioned fluids. This
includes before vaginal exams, handling of the newborn, touching feminine hygiene equipment
or blood/fluid soiled linens and towels and any time blood is handled i.e. blood draw or handling
of the placenta or other tissue. Hands must be washed both before donning gloves and after.
Gloves must be changed frequently and must be disposable.
In the case of water birth, shoulder-length gloves are recommended. Putting hands in water
should be kept to a minimum.
Disinfection of environmental surfaces and reusable equipment:
IMMEDIATELY BEFORE AND AFTER USE:
All examination rooms, labor rooms and birth rooms must be sanitized in accordance with
OSHA requirements.
Every surface must be washed and wiped down using antimicrobial product such Chlorine
Bleach or Cavicide- effective against TB, HBV, HCV, viruses (hydrophilic and lipophilic),
bacteria (including MRSA and VRE) and fungi. It is safe for all areas of the facility including
NICU, operating rooms, isolation rooms, patient care areas and laboratories.
Surfaces include but are not limited to floors, any tables, sinks, showers, tubs, handles, and
faucets.
Surfaces of pens, trash cans, stethoscopes, dopplers, and thermometers (all types) must be wiped
down after birth.
Birth tub must be wiped down with Cavicide (or other similar ant-microbial product), inside
must be washed with chlorine bleach. Water pump must soak with chlorine bleach and then the
water be allowed to run through for 5 minutes. Tub must be packed up immediately after
sanitization and stored in dry, cool place.
Outside the tub cover must also be wiped down.
Upon filling of tub, 1 cap-full of chlorine bleach may be placed in the water before mother
submerges. Mucosa, feces and vaginal secretions must be removed immediately from tub with a
fish net and discarded in bio-hazard waste. Brand new, disposable liner must be used in an
inflatable birth tub. Water must not remain stagnant. Regular introduction of fresh water and
draining of some water is recommended to reduce the risk of microbial growth.
LAUNDRY:
All linens/towels/bedding/carpets soiled with blood or other bodily fluids must be doused with
Hydrogen Peroxide and placed to wash immediately with cold water and chlorine bleach. It is
best to allow linens to soak for 1 hour prior to wash.
All beddings and towels must be replenished.
Placenta/Cord/Amniotic Sac (After-birth)
If placenta is being used by the client, it must be stored in double plastic bag in the refrigerator or
freezer.
If the client does not want to use the placenta, the placenta must be disposed of in a regulated
waste container and a pick-up must be scheduled accordingly. It may not be thrown in regular
trash containers.
OSHA requirements for incident reporting
Within eight (8) hours after the death of any employee as a result of a work-related incident, you
must report the fatality to the Occupational Safety and Health Administration (OSHA), U.S.
Department of Labor.
Within twenty-four (24) hours after the in-patient hospitalization of one or more employees or an
employee's amputation or an employee's loss of an eye, as a result of a work-related incident,
you must report the in-patient hospitalization, amputation, or loss of an eye to OSHA.
By telephone or in person to the OSHA Area Office that is nearest to the site of the incident.
By telephone to the OSHA toll-free central telephone number, 1-800-321-OSHA (1-800-321-
6742).
By electronic submission using the reporting application located on OSHA's public Web site
at www.osha.gov.
(OSHA, 2012)
 References
Davis, E. (2012). Heart & Hands: a midwifes guide to pregnancy and birth. Berkeley: Ten
Speed Press.
MCU Conference: Prenatal care class: Universal precautions in midwifery care, 10/18/17.

United States Department of Labor, Occupational Safety & Health Administration

(2012). Standard 1910.1030: Bloodborne pathogens. Retrieved
from: https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS
&p_id=10051 (Links to an external site.)Links to an external site.
United States Department of Labor, Occupational Safety & Health Administration
(2014). Standard 1904.39: Reporting fatalities, hospitalizations, amputations, and losses of
an eye as a result of work-related incidents to OSHA. Retrieved
from: https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS
&p_id=12783