In 2010 midwife Jennifer Gallardo advised a VBAC mother in labor that the infant variable heart rates detected could be just fine and that she could choose to either stay at home or go to the hospital but that she would have to have a c-section there. She also stated that she couldn’t determine which would be safer , giving birth at home or going to the hospital where the infant would likely have respiratory problems. Ms Gallardo did not call anyone to consult, nor did she call 911. Just prior to the mother beginning to push the midwives could not detect the fetal heart tones. Allegedly they finally detected a heart rate and the infant was born blue and unresponsive. Ms Gallardo did not then call 911, instead she attempted to resuscitate the infant herself asking the distraught parents if they wanted to call 911.
Questions to consider:
- Did Gallardo fully inform the parents that variable decelerations are caused by compression of the umbilical cord and are widely considered a highly ominous sign for a baby? That “a persistent variable deceleration pattern, if not corrected, may lead to acidosis and fetal distress”? Did she inform them that if left untreated, the baby could be born brain damaged, severely ill, or even die? (Info on FHR monitoring: http://www.aafp.org/afp/
- Did Gallardo overstate the risks of c-section? Did she inform them that the maternal mortality rate for a c-section is only about less than 20 in 1 million, whereas the risk to her baby continuing labor in severe distress is far, far higher?
- Fetal distress of this type is an absolute risk criteria (page 17: http://www.oregon.gov/OHLA/
DEM/docs/DEM_rules/DEM_4-4-11_). Did Gallardo inform the parents of this, that state rules demand she transport in that situation? Or did she tell them to decide without giving them that information? Why would she let them make a decision that could cost her her license and livelihood, not to mention the life of the baby, rather than making the call to 911 herself, as the rules demand? 5-19-11_9-1-11_Temp_Rules_ Final.pdf
- Why was 911 not called when the baby was born blue and unresponsive? This is also an absolute risk criteria. Common sense even dictates that anyone who is caring for a baby who is blue and unresponsive should call 911 immediately, even if that person is trained in CPR. Why did Gallardo fail to follow both common sense and the rules and guidelines established to hold a DEM license in Oregon?