Not even a pandemic could end this lifelong dream. Going to school while working full time and raising a family didn’t stand in the way either. Some things are just meant to be.
That’s how Naomi Elizabeth Drucker, MSN, CNM, Bridge 138, and Lilit Baldjyan Sarkissian, RN, MSN, CNM, Class 143, felt when they held a grand opening for Los Angeles Midwives on December 16, 2020. The grand opening was virtual, but the building, the practice, the midwives, and their guests were all quite real. It was the fulfillment of a dream that Drucker and Sarkissian shared when they worked together as labor and delivery nurses at Cedars-Sinai Hospital.
“Even when I was a registered nurse, I knew I wanted to be a midwife,” Sarkissian said. “I saw that in Naomi and I saw that in me too. We never officially talked about where we would be today but we jokingly referred to starting our own practice. The reality of it happening sounded too good to be true.”
While they had secured office space in September, the December grand opening event made it all feel real. The event lasted approximately 90 minutes with a large percentage of the 75-plus RSVP’d guests dropping into the virtual event for at least a part of the celebration. Among those in attendance were doulas, nurses, and nurse-midwives. Among the many notable attendees were the President of the California Nurse-Midwives Association and FNU graduate Paris Maloof-Bury, CNM, Class 140; FNU graduate Shadman Habibi, CNM, Class 19, lead CNM with the UCLA Nurse-Midwives; and Kathleen Belzer, the President of the California Nurse-Midwives Foundation. Activities included a virtual tour of the facility, an introduction to the nurse-midwives, and some interactive games and conversations.
“The grand opening raised awareness among other midwives and birth workers so they have a clearer understanding of what we are doing and what we have to offer,” Drucker said.
One of the unique things that Los Angeles Midwives has to offer is in-patient delivering privileges at Cedars-Sinai Medical Center, allowing them to provide midwifery care and services to their patients while having their babies in the hospital setting. Drucker and Sarkissian are the first CNM team to have such privileges at the hospital.
“Almost all of our clients come to us instead of another midwife because they know we have access to Cedars,” Drucker said. “For anybody planning an out of hospital birth, it’s very important to have a solid backup plan. We’re the only ones who can offer a seamless transition to the hospital without losing your birth team. That’s very important to all of our clients.”
Equally important to current and prospective clients is the strong reputation that Drucker and Sarkissian carry within the profession.
“Most of our inquiries are coming from a recommendation from doulas,” Sarkissian said. “Word of mouth in this business is so powerful because there’s a trust component. I trust my doula and my doula trusts you, so I’m going to trust you.”
Those connections with doulas and others in the birthing community have been developed over long periods of time. Drucker began her career as a doula 20 years ago and has continued to value and maintain those relationships over the years.
The Los Angeles Midwives recognize the importance of building trust and have established virtual Sunday meet and greets to better get to know their prospective clients. Working in the hospital setting, they saw first-hand the importance of having trust and a healthcare advocate during the birthing process. While working as labor and delivery nurses, Drucker and Sarkissian both took note of things they would do differently if and when they had their own practice. Drucker frequently jokes that she was an undercover midwife working as a labor and delivery nurse.
“There was one midwife at Cedars who had a private practice before we did,” Drucker said. “I would often ask her questions because I knew that down the road that’s what I wanted to do. My biggest concern was leaving a big institution where I get a great paycheck and have benefits. She said that will be the least of your worries. Your biggest worry is going to be finding a partner so you don’t kill yourself with the hours. I gained a lot of confidence from her. There is enough interest for sure, definitely for the special service we are offering that includes access to the hospital.”
Drucker worked independently for the first two years after leaving her nursing job, while Sarkissian took a full-time nursing instructor role at West Coast University (WCU) shortly after passing her national board certification.
“As a labor and delivery nurse, you really get to support these women in labor and help them make decisions and advocate for them,” Sarkissian said. “What drives you to become a midwife is when you see all of this in a medical setting and you can’t help but think to yourself ‘I wouldn’t have done it that way’ or ‘I wish she wasn’t coerced into that decision.’ You want to be in that seat where you’re making those decisions and managing her care. I want to be able to empower these women to be part of their own healthcare decisions. That’s one of the hallmarks of midwifery that we don’t see playing out the majority of the time in a medical setting.”
While Sarkissian was teaching at WCU, and concurrently serving as a clinical instructor at UCLA’s School of Nursing, she remained focused on her mission to join Drucker as a private practice midwife. Drucker guided her through the process of attaining delivering privileges.
“I left my job to get privileges while I taught full time. Naomi guided me throughout the whole thing,” said Sarkissian, who continues to be clinical faculty at UCLA’s School of Nursing. “It’s scary to call doctors and say ‘will you be my backup provider?’ She already had all those conversations. The groundwork was there. Plus, working at Cedars as registered nurses, where we had a working relationship and trust definitely helped.”
The Los Angeles Midwives have hit the ground running, beginning the new year with approximately 20 pregnant patients and 10 postpartum patients. They estimate that about 80 percent of their patients prefer a home birth, but the hospital privileges are a comforting assurance.
“If we need to go to the hospital, I still get to continue to take care of my patient,” Sarkissian said. “With the rest of the great midwives who don’t have these privileges, if there’s a reason to go to the hospital, that care ends because they can’t go with them.”
Drucker estimates that only about 15 percent of the time do they need assistance from their backup provider, who would perform procedures such as C-sections at the hospital. But even in those cases where physician backup is required, Drucker and Sarkissian are still able to be there, actively involved in the care and advocacy of their patients.
That personal connection and care are just as important to the Los Angeles Midwives as they are to their patients. They understand that it is what makes them a success, and it is why they have no immediate plans to expand their business.
“It’s such a personal business and people really do come for us — not just a midwife — they are coming for us in particular,” Drucker said. “I imagine it would change the flavor of our service if we had a team of midwives.”
Both Drucker and Sarkissian are content with the size, scope, and model of their practice. They are quick to thank their families, friends, and colleagues for helping them reach this point. It takes an immeasurable amount of support to be able to work full time, go to school full time, and raise a family all at once. They also credit Frontier Nursing University with playing a key role in making Los Angeles Midwives a reality.
“Frontier has a stellar reputation,” Drucker said. “As far as securing clinical sites and promoting ourselves, people love to know that we went to Frontier. As a working mother of four sons, I worked the night shift through my whole master’s degree and it was doable. I couldn’t have done that with any other program. I’m really grateful. I’m also grateful for the on-campus experience that we had. It was manageable and it allowed us to connect and meet these great midwives who are so passionate about some facets of midwifery that I had never even considered to be important. I think Frontier gave me a great foundation. I’m very proud to let people know that I went to Frontier.”
“I had a baby who was one when I started school and had two other babies while I was in school, also working the night shift,” Sarkissian said. “That ability to be able to go to school and realize my dreams would have not been possible with any other school. That being said, it wasn’t just any online program. I always felt that connection, even though I was thousands of miles away. Frontier has it figured out. They know what it takes to educate students using an online medium but still have that connection. I felt supported and the knowledge that I received and the education that I got were top notch. That was even more clear to me when the pandemic hit and I was an instructor at a university and I had to teach online. I got to use a lot of the things I learned as a student as an instructor.”
“I am extremely proud and honored to have attended Frontier,” Sarkissian continued. “I think as a midwifery school, it is one of the top schools and I can see why they have that reputation. They have it figured out and it’s the right way to do it.”
The same could be said about the Los Angeles Midwives.