Andaluz Midwife Attends Fetal Demise; Doesn’t Call 911

In August of 2009 around 9:30 PM Jesica Dolin arrived to attend a home birth.  Without apparently assessing the mother or baby, Ms Dolin set up her equipment and then around 10:00 PM checked for a fetal heart rate. After trying for 20- 30 minutes no fetal heart tones could be determined. Ms Dolin did not at this time call 911 or consult a physician or anyone else, she instead told the parents they could have a choice to go to the hospital or stay home and deliver the baby.  No attempt was made to summon medical help and, and about 45 minutes later the infant was born without a heartbeat. Prior to the birth Ms Dolin had no way of knowing the condition of the infant or if indeed she had expired, without proper medical equipment.

http://jefferiesbebsite.blogspot.com/2009/08/story.html

Questions to Consider:

  1. With only a hand-held doppler, how could Dolin be certain that the baby had died? What if she had been mistaken? What if the baby had still had a faint pulse not detectable with the doppler and could have been saved with immediate transport? Did Dolin fully inform the parents as to the limitations of Doppler technology and the possibility that her assessment could have been erroneous?
  2. Failure to detect fetal heart tones in labor is an absolute risk criteria (page 17: http://www.oregon.gov/OHLA/DEM/docs/DEM_rules/DEM_4-4-11_5-19-11_9-1-11_Temp_Rules_Final.pdf). Why did Dolin not follow the protocol required by her license and call 911?
  3. Whose interests are served by deviating from protocol and creating the appearance that it was the parents’ decision to deny transport?