O.C. Midwife’s Actions Contributed to Death of Baby, Officials Say

In what is believed to be the first criminal prosecution of a licensed midwife in California, Orange County prosecutors have charged a former Orange woman with contributing to the death of a stillborn baby by illegally injecting the 37-year-old mother with a labor-inducing drug.

Prosecutors charge that the midwife, Lori Jensen, 46, broke a law prohibiting midwives from administering drugs without the supervision of a doctor, a felony that carries a three-year maximum prison term.

Jensen is the first midwife to be charged for such an offense since licensing began in 1997, according to Faith Gibson of Palo Alto, director of the California College of Midwives. The case also threatens to derail midwives’ efforts for greater authority during childbirth.

Jensen, who moved to Hawaii after the 1998 stillbirth, has pleaded not guilty. She also is under investigation by the Medical Board of California, which has the power to revoke her license.

Deputy Dist. Atty. Ebrahim Baytieh said Jensen downplayed concerns about the mother’s health and injected her with Pitocin, a labor-inducing drug. Jensen also allegedly told the parents, Caroline and Michael Phan, to lie about the injection to hospital emergency room staff, according to prosecutors.

“When you trust someone to deliver your child, it’s only fair that you would expect them to do everything according to the law,” Baytieh said. “We believe the evidence will prove that Lori Jensen did not do that.”

Jensen, who did not appear at a pre-trial hearing in Santa Ana on Friday, was not available for comment. Her attorney, M. Joseph Heneghan, declined to comment other than to say that Jensen is “certainly not guilty.”

Since the passage of state licensing requirements in 1993, 111 midwives have been authorized to assist childbirths. In 1999, 3,000 of the state’s 600,000 babies were delivered by midwives, according to the California Medical Assn.

The Phans said Jensen came highly recommended by several friends. The San Juan Capistrano residents wanted a natural childbirth, believing it would be the best thing for their baby, and were initially impressed with Jensen’s charismatic personality.

But now they believe Jensen’s negligence led to their baby girl’s death.

“I think she should go to jail,” Michael Phan said. “When someone has taken your child’s life, you want them to pay.”

The Medical Board of California alleges that Jensen ignored warning signs of Phan’s deteriorating health and that she insisted that Phan did not need to see a physician. Several weeks after they hired Jensen, Caroline’s blood pressure had begun to rise, according to the board’s allegations.

Instead of referring her to a doctor, the Phans said Jensen told Caroline to stay in bed and elevate her feet.

The medical board, in a complaint filed with the state Department of Consumer Affairs, also accused Jensen of ignoring the recommendation of an ultrasound technician on Nov. 3, 1997, who stated that labor should be induced the next day. The technician recommended the action because of Phan’s low level of amniotic fluid.

Three weeks beyond her due date, Caroline Phan said she agreed to take the labor-inducing drug on Jensen’s recommendation. Phan said she did not know that Jensen was exceeding her authority as a licensed midwife.

After hours of intense labor, with the baby still in the womb, Jensen announced she could no longer hear the baby’s heartbeat with her monitor, according to the state medical inquiry. Caroline Phan was rushed to an emergency room where the baby was pronounced dead. The coroner’s report indicated the baby inhaled its fecal waste, a sign of a lack of oxygen.

The case comes at a time when midwives are pressing for changes to a state law that they say forces them into becoming reluctant lawbreakers. Many midwives are unable to get state-required medical supervision because insurers prohibit doctors from participating in midwife deliveries, according to Sue O’Connor, chairwoman of the California Assn. of Midwives.

“The problem is the law requires supervision, but the reality is you can’t get it,” O’Connor said. “It’s a Catch-22.”

She said the case could hurt passage of legislation that would allow midwives to perform deliveries without direct supervision.

“I don’t think [the case] helps,” she said.

Despite the negative publicity, O’Connor and others say it is an isolated case and that most midwives provide an important service for expectant mothers.

“We’ve been giving birth for thousands of years without medical intervention,” said Gibson, of the California College of Midwives, herself a midwife of 20 years. “What I do is provide a psychological and emotional support for the mother.”

Medical groups remain strongly opposed to relaxing the current law, saying parents take risks in having a baby at home without the presence of a physician. Bob McElderry, associate director of government relations for the California Medical Assn, said expectant mothers should be guaranteed the highest quality of care.

“It’s best to have a physician there. They have the most training and can handle emergency situations,” he said. “The bottom line is we’re not talking about one life, we’re talking about two.”