‘A Part of Somebody’s Miracle Every Day’

Karen Perdion spends a lot of time running up and down stairs.

As the director of the nurse-midwifery service at University of California, San Diego Medical Center, she goes back and forth between the birth center on the fourth floor, where women are freer to move about during labor and generally have unmedicated births, and labor and delivery on the second floor, where more traditionally monitored births occur. She provides emotional and physical support to women during labor, which can include playing music, massaging a mom-to-be’s shoulders or helping to deliver the baby.

As a certified nurse-midwife, she’s licensed and trained to take care of women with normal, healthy pregnancies. She’s not a doctor but can do more than nurses, like administer prenatal care — the battery of tests to make sure the mother and baby are healthy.

Perdion, 43, got turned onto midwifery after reading a newspaper article when she was in high school. “That just sounded like the perfect job,” she said. She went on to get bachelor’s and master’s degrees in nursing and a certification in midwifery. In the 17 years she’s been a certified nurse-midwife, she’s delivered more than 2,000 babies.

The morning we were supposed to meet for an interview, Perdion called to reschedule because she had to cover for someone in labor and delivery. She ended up with two births.

When we finally met, we talked what it’s like to be a midwife who hasn’t had kids and how a simple “How are you doing?” can be the key to building trust.

When women come to you, why do they tell you they’ve chosen a midwife?

Most choose midwifery because they want a more personal experience, a less medical-oriented experience. We believe in their bodies, that women are capable of having a normal pregnancy, growing a normal baby, giving birth. We definitely do all the same tests that physicians usually do for pregnancies, we want to make sure that mom and baby are healthy, but we also want to know how she’s doing, how her life is going and what’s going on beyond just the physiological changes.

I asked a mom one time how she was doing and she’d transferred from some other hospital and she said she actually liked her physician that she had transferred from but in the whole pregnancy he’d never said “How are you doing?” And that just struck me because that’s a normal part of my visit.

I think another part of what we do is that women are educated about what’s happening. I want women to make the best choices for their pregnancy and for their birth, so whenever it’s possible for them to make a decision and choose what happens, as long as it’s a safe option, I want them to choose what’s best for them and not tell them what to do.

How do you build up the trust with someone about something so personal?

One thing that I miss doing because I do a lot more administrative duties is that I don’t get as much of an opportunity to meet as many women before they come to the hospital. We have six sites where we have prenatal care and we try to keep the same midwives at those sites so women can develop a relationship with the midwife they’re seeing prenatally. They’re not necessarily the person that’s going to be there when they give birth because we do 12-hour shifts. What’s very important is that we all share the philosophy. We all practice with the same guidelines, because when we add people, they are going to practice with the same philosophy. I want to know, that at the end of my 12-hour shift, if somebody is in labor, that they are going to manage with the same philosophy that I would’ve used, that they’re not going to suddenly change things.

How has midwifery endured?

Midwives have been around for centuries, for a long time, since the Bible. In most countries midwives are still the primary birth attendants (though) there are certainly physicians. In the United States, initially there were a lot of midwives, then physicians took over birth, there were a lot of changes and birth moved into hospitals, and there were a lot of good things that came out of that.

It also pushed midwifery to make it seem like it was a fringe element. Then in the last 40 years, we’ve created more official education programs and certification and we are part of the mainstream now. There are still midwives who do home births and there a lot of people who still think that everyone who is a midwife does home births but now there are so many of us, it’s less of an issue. People are not surprised to have a midwife. There’s a big practice at Kaiser, at the Navy, in North County delivering at Tri-City Hospital, at Palomar.

Do you have children?

No I don’t.

Do women ever ask you if you have kids?

I definitely get asked. I tell them what I know about what is normal and what things are going to feel like from what I can imagine and what I’ve seen. I think I can relate to it better than a male who has never had a baby but it’s never really been an issue.

Do you feel challenged in those moments where you can’t relate to the physical sensations?

Probably when I first started I did a little bit but now that I’ve done it so much and I have enough friends that I can say to, “No, really, tell me exactly, what did it feel like?” and from what lots of patients have told me, I feel like I know enough. One of my mentors, she also didn’t have kids, and I asked her, “Do you feel like that challenges you?” and she said, “Having had either a good or bad birth experience yourself can affect what you expect (for) your patients’ birth experiences.” I have no preconceived notion based on my own experience on what they should or shouldn’t choose for their own labor, how they should cope. I just have my professional experience of being with women, so I think it may be a benefit.

What’s the most rewarding part of the job?

The mom getting to hold her baby for the first time. It’s after going through all the months of growing a baby, giving birth to a baby and working really hard in labor — you don’t call it labor because it’s easy — and just to see her and all the family see the baby for the first time, is worth more than anything. We get to be a part of somebody’s miracle every day.

Interview conducted and edited by Dagny Salas. Want to chat? Email me at dagny.salas@voiceofsandiego.org or call me at 619.550.5669. I’m on Twitter too: twitter.com/dagnysalas.