karen merzenich

Spotlight Profile

Karen Merzenich, Certified Nurse Midwife

I changed careers to become a nurse midwife at age 40, having previously worked as a chef, a cooking instructor, a non-profit leader, and an internet marketer. I am fortunate now to have 2 wonderful, hilarious, healthy children. But, in between them, I suffered a devastating pregnancy complication which resulted in me being hospitalized for a month and my child passing away at 6 days old. This kind of tragedy commonly spurs a reckoning and reevaluating of life, and that was certainly the case for me. As I reflected on my situation, I started to look into what kinds of things people were doing to improve health for pregnant people and babies, especially for the most vulnerable and marginalized. I realized that what I most wanted to do with the rest of my work life was to take care of people and families through pregnancy, and I recognized that my own experience would allow me to have a unique ability to support patients and fully empathize with them. Globally, the field of midwifery has an absolutely amazing track record, on the whole, for improving birth outcomes, reducing complications like preterm birth, and lowering rates of maternal-fetal morbidity and mortality. So it was clear to me that becoming a nurse midwife was my path, and that has been absolutely the best decision I could have made.

I also knew that I would commit to providing care to those patients who have the most challenges accessing it, so it was never really an option NOT to work at an FQHC or community clinic.

What are the services like for pregnant patients at CommuniCare+OLE?

We offer “perinatal services,” which allow us to provide wraparound care to support our patients and their families before, during, and after pregnancy. We have Certified Nurse Midwives that take care of pregnant patients through their pregnancies, help them plan their families, and give guidance and resources postpartum. A key piece of our care is the Comprehensive Perinatal Services Program (CPSP). It is a Medi-Cal benefit that provides a wide range of culturally competent services to pregnant individuals from conception through 60 days postpartum. In addition to standard obstetric services, patients receive enhanced services in the areas of psychosocial, health education, dental, and nutrition.

What is the prenatal/perinatal care landscape Up Valley like?

For some time, we only offered perinatal care in Napa, and I noticed that so many patients were diligently traveling from Up Valley to Napa each month for their prenatal appointments. It can be a huge burden, and a barrier to care, to expect people to take time off work, spend money on gas, find transportation, and so forth – just to take care of themselves and their pregnancy. I couldn’t believe how many patients were coming all the way from Calistoga, St. Helena, Pope Valley, and even farther afield like Middletown and Clearlake, to make it to their visits in Napa. And, we expect them to come frequently for prenatal care, so it could add up to 1-2 visits per month. I realized it made a lot more sense for one midwife to drive a bit farther, than for all of the patients to have to travel so far! That’s how our perinatal services made it to Calistoga, and patients have expressed gratitude for the ability to care for themselves and their families without having to face as many hardships and stress around their appointments.

As providers we are often reminded that in order to provide patient-centered care, we should “meet patients where they’re at” – and usually this means to consider where patients are in their mental state, their journey, their opinions, and their preferences. In this particular case, that phrase was more literal – and to “meet patients where they’re at” meant to provide care in their community by bringing a nurse midwife Up Valley.

We have the same resources in our clinic that we have at our other locations, including ultrasound machines for the first visit! Unfortunately, it’s still tough for patients Up Valley to access a lab to get their bloodwork done, because there is no Quest lab here in Calistoga. When they need specialty visits for more detailed ultrasounds or consultations, our resources are even more limited. Patients have to travel to Marin County, San Francisco, or Walnut Creek when they need to see Maternal Fetal Medicine doctors or get their specialty ultrasounds done. I look forward to being able to expand our care so we can break down more of these burdens for patients. But I am glad we have made a start.

What has been the most rewarding part of your time with CommuniCare+OLE?

I did a rotation at OLE Health before graduating from UCSF School of Nursing and knew then it was the place I most wanted to work in the whole Bay Area. I love the high quality of care we provide at CommuniCare OLE, I love the supportive teamwork, I love the positivity and dedication, and I love the tenderness and caring we show to our patients. Every day I get to see coworkers who are going the extra mile for patients and putting in such amazing efforts to help the community. And it’s incredible to have the opportunity to take care of families, build relationships over time with patients, and see the positive impact we have on the community at large. I learn so much from our patients every day and am so grateful to get to spend time with them, working together for the best and most patient-centered pregnancy they can have.