Latest / MyMaine Birth / 8. Mid-week midwife edition, Melissa Tomback journey from Doula to nurse midwife

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8. Mid-week midwife edition, Melissa Tomback journey from Doula to nurse midwife · MyMaine Birth

• 0:01
  Speaker 1: I'm Angela and I'm a certified birth photographer, experienced doula, childbirth educator and your host here on the my Maine Birth podcast.
• 0:09
  Speaker 1: This is a space where we share the real-life stories of families and their unique birth experiences in the beautiful state of Maine, From our state's biggest hospitals to birth center births and home births.
• 0:22
  Speaker 1: Every birth story deserves to be heard and celebrated.
• 0:26
  Speaker 1: Whether you're a soon-to-be mom, a seasoned mother or simply interested in the world of birth, these episodes are for you.
• 0:34
  Speaker 1: Welcome to episode 8 of the my Main Birth podcast.
• 0:40
  Speaker 1: Today's birth story guest is Melissa Tombach, and we're going to be hearing her share about her experience birthing her daughter in a hospital and her experience birthing her son at home.
• 0:49
  Speaker 1: Melissa has been a doula in Maine for 10 years now.
• 0:53
  Speaker 1: She helped to create the Community Doula Birth Program, which is a nonprofit organization that provides reduced-cost doula services to low-income families.
• 1:01
  Speaker 1: Melissa also shares about the experience that led her to pursue midwifery and why she chose the CNM or Certified Nurse Midwife path, and a little bit about what that journey will look like for her.
• 1:12
  Speaker 1: Hi, Melissa, Welcome to my Main Birth.
• 1:16
  Speaker 1: Hi.
• 1:17
  Speaker 1: So, to get started, can you share a little bit about when you found out you were pregnant and the care you chose?
• 1:23
  Speaker 2: We decided on January 1st that we would try having a kid and I was pregnant on January 4th.
• 1:31
  Speaker 2: So whatever, whatever, I was pregnant that month and we were living in well, at the time we were living in Cambridge and we looked for a house.
• 1:46
  Speaker 2: We ended up buying a house in Wayland um, massachusetts, and I don't yeah, I'm trying to remember I think we, yeah, we already lived there when Talia was born.
• 1:59
  Speaker 2: So I, the doctor I had it was a, I don't remember her name.
• 2:06
  Speaker 2: I remember who delivered Talia, but I don't remember her name and in retrospect she was just a typical traditional doctor.
• 2:15
  Speaker 2: I was completely healthy.
• 2:16
  Speaker 2: I had absolutely nothing wrong the entire pregnancy.
• 2:19
  Speaker 2: I worked.
• 2:19
  Speaker 2: I was a lawyer, I was a criminal defense attorney.
• 2:22
  Speaker 2: I was working during pregnancy.
• 2:24
  Speaker 2: I had no morning sickness.
• 2:27
  Speaker 2: I mean I was like happy.
• 2:29
  Speaker 2: I was in a great mood when I was pregnant.
• 2:31
  Speaker 2: I mean I'd be pregnant again today if I could, but that's not possible.
• 2:39
  Speaker 2: And I chose hospital care because I really knew nothing about birth, like most women.
• 2:45
  Speaker 2: I think, going into birth like we're not really taught anything, and so you go to the hospital, have a baby, like right.
• 2:52
  Speaker 2: So my ex worked at Massachusetts General Hospital, so we just picked a doctor there I did pick.
• 3:00
  Speaker 2: What I do remember about the woman is she was a black woman, so I picked her because she was just mainly based on that.
• 3:09
  Speaker 2: She was really highly educated, seemed really smart, and I thought that that would be someone who was maybe a little more outside the box, maybe, but she wasn't.
• 3:20
  Speaker 2: And so then anyway, and Talia's birth was, uh well, she came very early, like not very, but two and a half weeks early, early enough that I wasn't expecting her to come.
• 3:35
  Speaker 2: Um, I was actually at the mall and I have no idea what I was doing, but my water broke and it was not a little trickle, it was, it was a, like a, it was everything.
• 3:48
  Speaker 2: I went to the gap and I bought clothing because I was soaked.
• 3:53
  Speaker 2: I did call the doctor and I was like you have to come in, and at the time my husband was in New York speaking, and so I called him and he like made an announcement he's like I have to go, my wife's water's just broke.
• 4:06
  Speaker 2: So he took a plane home and I think we finally went in at like midnight or close to midnight.
• 4:13
  Speaker 2: When he got back I was not in labor, nothing was happening, and I remember they checked me and I was nowhere, like I was not effaced, I was not dilated or whatever, and they immediately wanted to induce me.
• 4:27
  Speaker 2: But back then induction looked a little different.
• 4:29
  Speaker 2: They literally start with Pitocin, like they don't do all the pre, you know, they don't do any cervical ripening.
• 4:35
  Speaker 2: And for whatever reason, because I knew nothing, I said no.
• 4:40
  Speaker 2: I don't know why I said no.
• 4:44
  Speaker 2: I remember I mean I was having contractions by then, but nothing major.
• 4:49
  Speaker 2: So they put me in a room and the next morning some resident came in and she wanted to check me and I remember like nothing, nothing really had changed.
• 5:01
  Speaker 2: I was having contractions, but not anything that would have Nothing really had changed.
• 5:02
  Speaker 2: I was having contractions, but not anything that would have.
• 5:04
  Speaker 2: I mean, at the time I didn't know that.
• 5:06
  Speaker 2: But looking back, nothing that would have dilated me or gotten me anywhere.
• 5:11
  Speaker 2: And for whatever reason, I intuitively said well, it doesn't seem to make sense for you to stick your hands inside me.
• 5:18
  Speaker 2: My water's broken.
• 5:19
  Speaker 2: Won't that cause an increase in chance of infection?
• 5:22
  Speaker 2: And she's like, yeah, and then I said oh, let me guess you're going off your shift and you want to put a note in your chart, or put a note in the chart that says I don't want to be, I refuse the examination.
• 5:33
  Speaker 2: And so she left.
• 5:34
  Speaker 2: And then Dr Blattman came in later, who was the person delivered Talia and said I heard that you don't want to be induced.
• 5:42
  Speaker 2: I'm not going to check you because I don't want to increase the chance of infection.
• 5:47
  Speaker 2: And he left me.
• 5:50
  Speaker 2: But the other thing that was happening is I was not allowed to eat because back I mean, this is Talia's 25.
• 5:56
  Speaker 2: So it's not that long ago that you couldn't eat during labor in the hospital.
• 5:59
  Speaker 2: But the nurse is like well, we can't stop you from leaving the hospital and going to get something to eat, which was just absurd, thinking back on it.
• 6:09
  Speaker 2: So we left the hospital in like the middle of the day and went down to Charles Street and I think we went to Rebecca's or something.
• 6:16
  Speaker 2: I got some soup, but I'm having contractions like walking.
• 6:20
  Speaker 2: You know, like now they're like every 10 minutes.
• 6:23
  Speaker 2: You know, now they're getting closer, I'm sort of keeling over on the sidewalk and whatever.
• 6:27
  Speaker 2: We got something to eat.
• 6:28
  Speaker 2: We went back and eventually at some point I finally said fine, and I was like I was having contractions, but never got into a great pattern.
• 6:40
  Speaker 2: But when they gave me that Pitocin.
• 6:42
  Speaker 2: They don't start it back then.
• 6:44
  Speaker 2: They did not start it like at a two and titrate up slowly.
• 6:47
  Speaker 2: They started at much higher and when that Pitocin hit me, I was, I was done.
• 6:54
  Speaker 2: I was like you gotta be kidding me.
• 6:55
  Speaker 2: And so I was like give me an epidural.
• 6:57
  Speaker 2: So I had an epidural.
• 6:59
  Speaker 2: I remember taking a nap.
• 7:02
  Speaker 2: It wasn't that long afterwards.
• 7:03
  Speaker 2: I mean, she was born at like 945 at night that I was fully dilated and I pushed her out in like 45 minutes and she was actually posterior, which explains why my contractions never got in a good pattern.
• 7:16
  Speaker 2: And yeah, so she, I pushed her out in 45 minutes.
• 7:20
  Speaker 2: They placed her on my chest and she pooped all over me and that was Talia's birth.
• 7:28
  Speaker 2: They cleaned me off and then they taught I remember nursing on the other side that she hadn't pooped on.
• 7:34
  Speaker 2: And you know, as, as a hospital birth goes, it was fine.
• 7:40
  Speaker 2: I mean, there was it.
• 7:41
  Speaker 2: You know it wasn't.
• 7:42
  Speaker 2: You know people describe their, describe their birth as awful and the hospital was.
• 7:47
  Speaker 2: You know I wouldn't say that the hospital birth was fine.
• 7:51
  Speaker 2: What I hated about it the most was that, because my water had broken for more than 24 hours, they gave me antibiotics and I had a history of bronchitis and stuff, and whenever I took antibiotics I would get a yeast infection.
• 8:05
  Speaker 2: So the day or two after I'm in the hospital I was like I have a yeast infection, and the doctor said, nah, it's just the aftermath of the birth.
• 8:13
  Speaker 2: And I was like, no, you gave me intravenous antibiotics and I know what a yeast infection feels like.
• 8:20
  Speaker 2: This is a yeast infection.
• 8:21
  Speaker 2: And I said not only that, talia's mouth is filled with um thrush, she already had a thrush, you know.
• 8:29
  Speaker 2: So it took two to three months of to get rid of the yeast.
• 8:34
  Speaker 2: It must have been resistant.
• 8:36
  Speaker 2: Nystatin didn't work.
• 8:37
  Speaker 2: They gave me all sorts of stuff.
• 8:38
  Speaker 2: Eventually I did gentian violet, which is an old midwifery like an old ancient herb that people use that there's controversy over.
• 8:47
  Speaker 2: I finally just used it and in two days it was gone.
• 8:50
  Speaker 2: And it wasn't then that I said, oh, next I'm going to go birth at home.
• 8:54
  Speaker 2: Because I didn't even know you could birth at home I started hanging out with at a Waldorf school and everybody at Waldorf, you know, they all give birth at home.
• 9:04
  Speaker 2: So that's how I ended up there.
• 9:07
  Speaker 2: So then, jacob, I was for sure not going back to the hospital.
• 9:12
  Speaker 2: I did have one complication with Talia she, I was ABO, I had a blood incompatibility with my, with my ex and um she had coom or I had cooms.
• 9:23
  Speaker 2: I'm not sure if it's the baby or it's me, but enough that the body fights.
• 9:27
  Speaker 2: The baby's body was fighting that, so it didn't fight Billy Rubin.
• 9:31
  Speaker 2: So her Billy Rubin shot really high the first day so she ended up under lights and I knew that I had like 85% chance that that happened again with my second.
• 9:43
  Speaker 2: So we got I got home health to deliver a light tape.
• 9:48
  Speaker 2: I had a light table at home for in case that happened again and in fact it did happen again we use the light table.
• 9:55
  Speaker 2: But I actually ended up back in the hospital with Jacob because of high Billy Rubin.
• 10:01
  Speaker 2: The doctor sent me in so I did have a home birth, but the next day I was in the hospital.
• 10:07
  Speaker 2: So the home birth, I mean there's like nothing to tell.
• 10:12
  Speaker 2: I started labor at six.
• 10:13
  Speaker 2: Midwife got there, I don't know, maybe midnight.
• 10:16
  Speaker 2: I yelled at her that I could, that I had made a mistake, I needed to go to the hospital, I needed drugs.
• 10:23
  Speaker 2: There was no way I was doing this.
• 10:24
  Speaker 2: And she's like let me check you.
• 10:26
  Speaker 2: And you know she's taking her time.
• 10:29
  Speaker 2: And she checked me and she's like you're not going to make it to the hospital, you're about ready to push.
• 10:33
  Speaker 2: And I was like, oh okay, sure I can do this.
• 10:37
  Speaker 2: And I pushed him.
• 10:39
  Speaker 2: I pushed twice.
• 10:40
  Speaker 2: That was it the first time I pushed.
• 10:42
  Speaker 2: It was like I was crowning and so it killed.
• 10:44
  Speaker 2: I was like, oh my God, I get this over with.
• 10:46
  Speaker 2: And I just pushed with all my might and he was out.
• 10:48
  Speaker 2: But then I had a visiting doctor come and she got scared with his Billy Rubin numbers and so she sent me into the hospital.
• 10:59
  Speaker 2: The next day he was born at two in the morning.
• 11:00
  Speaker 2: So I think I was that following night I was in the hospital and we were there and then the next day they put him under the lights, which is exactly what I would have done at home.
• 11:08
  Speaker 2: They did nothing more for him.
• 11:10
  Speaker 2: For Talia, they had given her an IV to flush out, you know, so she'd pee out the bilirubin.
• 11:16
  Speaker 2: They didn't do that.
• 11:18
  Speaker 2: I was at Newton Wellesley and the next morning the numbers had gone down and the doctor was like, what's this baby doing here?
• 11:26
  Speaker 2: I was like you got to be kidding me.
• 11:27
  Speaker 2: So we left.
• 11:27
  Speaker 2: I mean, that was the end of that.
• 11:33
  Speaker 2: So it was one night.
• 11:34
  Speaker 2: It wasn't awful, but what was hard is that I didn't have a room because I was not a patient, so we were literally like in the hall, which is crazy.
• 11:39
  Speaker 1: So that is pretty crazy.
• 11:41
  Speaker 1: So your water broke in the mall with Talia and the nurses were definitely advocating for you to be like go get a sandwich downtown.
• 11:51
  Speaker 2: I know it made no sense.
• 11:52
  Speaker 2: It doesn't seem like it should, that it was so long ago.
• 11:55
  Speaker 2: You know long ago that we couldn't eat and that you know things change.
• 12:00
  Speaker 2: So when did you make the move to Maine change?
• 12:10
  Speaker 2: So when did you make the move to Maine 2012.
• 12:11
  Speaker 2: We were living in Newton and I grew up in New York and Newton was just like that, all obsessed with like money and cars and wealth, and my son was, like you know, driven by that.
• 12:20
  Speaker 1: By then we're like we got to get out of here.
• 12:23
  Speaker 2: So we moved to Maine Maine but he's still obsessed with cars and money and all that stuff.
• 12:28
  Speaker 2: So it didn't change my daughter's the opposite she's.
• 12:34
  Speaker 2: She's much more save the world personality and he's much more like take over the world personality, oh my gosh.
• 12:45
  Speaker 1: So what led you to take your doula training?
• 12:49
  Speaker 2: Well, it was Talia who said to me mom, you should go do something with like moms and babies Cause I used to go up to all these women who were pregnant and I would give them my lactate dot Norcross.
• 13:00
  Speaker 2: I still remember two, four, six, one, seven, two, four, four, five, five, nine Dot Norcross.
• 13:04
  Speaker 2: I still remember two, four, six, one, seven, two, four, four, five, five, nine, three.
• 13:06
  Speaker 2: I know her number by heart.
• 13:07
  Speaker 2: So if if it had not been for dot, I would not have, I would not have been nursing Like and in fact, when we move, the people who bought our house were pregnant and I gave them the number and they emailed us that had they not had dot, they would not have been nursing.
• 13:24
  Speaker 2: So when I saw the doula training, I said, oh, I should go check that out.
• 13:26
  Speaker 2: So I did it, and then it was 2015.
• 13:29
  Speaker 2: So I did the donut in 2013.
• 13:31
  Speaker 2: I think it was 2015 that I think we founded the community doula birth program.
• 13:37
  Speaker 2: It wasn't my initial idea.
• 13:38
  Speaker 2: I would probably say it was Rebecca Goodwin's initial idea.
• 13:43
  Speaker 2: She's still on the board and she'd gotten some a little bit of money from some buddy who was interested in starting this but didn't do.
• 13:53
  Speaker 2: Nothing really happened until Julie Virgin got herself a grant and she wanted to start.
• 14:00
  Speaker 2: She had, she wanted to start something and got connected to Rebecca and then they put word out that they were starting this and I was like, oh, I'm totally interested, I'll help you out.
• 14:10
  Speaker 2: And so there were like four of us maybe five in the beginning and we essentially just traded stuff.
• 14:17
  Speaker 2: Like Rebecca is a massage therapist, so she traded massages to get a logo made for us therapist, so she traded massages to get a logo made for us.
• 14:29
  Speaker 2: And Julie did a birth and got our website set up, um.
• 14:31
  Speaker 2: As a lawyer, I did all of the corporate.
• 14:32
  Speaker 2: I set the corporation up, I made us a 501c3, um.
• 14:37
  Speaker 2: So we all just sort of did stuff.
• 14:39
  Speaker 2: Um, and to, the fact that it still exists today to me is mind-boggling.
• 14:44
  Speaker 2: But we just sort of p peter, we always seem to have just enough.
• 14:47
  Speaker 2: I mean, we got one grant but we haven't gotten any money since.
• 14:51
  Speaker 2: And the way we survive is that we service people who have money and they pay us, and then we have money to serve the people who don't have money.
• 15:04
  Speaker 1: So the Community doula birth program provides doulas to low-income families and the program also mentors new doulas and helps them obtain their certifying births for them to become a certified doula right.
• 15:16
  Speaker 2: So the I mean, and we do keep some of our doulas have been with us like from the start.
• 15:21
  Speaker 2: Most of our doulas, like some of them, go on become midwives or they move or whatever.
• 15:27
  Speaker 2: But I would say that a lot of our doulas realize that certification is relatively meaningless and don't even bother.
• 15:36
  Speaker 1: Right, because anyone can create a doula training certification program.
• 15:41
  Speaker 2: Right, there's hundreds of them, so it's meaningless.
• 15:44
  Speaker 2: It's not like you know, when I was a lawyer, we all took the bar.
• 15:47
  Speaker 2: That's not like that.
• 15:49
  Speaker 2: It's not like the medical boards, you know it's.
• 15:52
  Speaker 2: It's so a certification.
• 15:54
  Speaker 2: There's no standardization.
• 15:55
  Speaker 2: You don't know what that means when someone's certified.
• 15:57
  Speaker 2: I had a client a repeat client that was birthing in New Hampshire and the hospital required me to be certified during COVID, which makes no sense.
• 16:09
  Speaker 2: It's not like that helps protect anybody from COVID.
• 16:13
  Speaker 2: But so I went and got cross certified by ProDoula.
• 16:17
  Speaker 2: I essentially paid money and now I'm certified for life.
• 16:20
  Speaker 2: I took a test, that was it.
• 16:24
  Speaker 1: All right.
• 16:24
  Speaker 1: So what made you decide to become a midwife?
• 16:27
  Speaker 2: So, last year on Mother's Day I had I had been doing some work at Crossroads.
• 16:33
  Speaker 2: Do you know what?
• 16:34
  Speaker 2: Crossroads is a treatment facility for drug addicted woman or alcohol addicted or substance addiction.
• 16:42
  Speaker 2: And there was a woman there that was due and she was discharged and I gave her the card for the program.
• 16:49
  Speaker 2: So she texts me in the like six in the morning and I'm usually up at that hour, but this time I wasn't.
• 16:56
  Speaker 2: I didn't get it to like.
• 16:57
  Speaker 2: I think she texted me at like three in the morning, I don't know.
• 17:00
  Speaker 2: I called her in the morning and she's like I really need help, will you come over?
• 17:04
  Speaker 2: And I was like I'm not going to say no.
• 17:06
  Speaker 2: So I went over.
• 17:15
  Speaker 2: I fortunately had a bag of gloves in the car from COVID and because this is still, you know, last year I mean COVID was still real and she was clearly pushing during contract.
• 17:23
  Speaker 2: I mean just from the sounds I could tell she was pushing during contractions.
• 17:26
  Speaker 2: I was like let me check you and I check her and like the baby's head's, like right there.
• 17:30
  Speaker 2: And I was like let me check you and I check her and like the baby's head's, like right there.
• 17:33
  Speaker 2: And I'm like, oh crap, that baby's coming on the next push because it wasn't her first baby.
• 17:38
  Speaker 2: And there was some guy downstairs who was sick.
• 17:41
  Speaker 2: He's like throwing up I don't know if he was throwing up from covid, if he like or was just had a cold, or he was like it was a drug related.
• 17:51
  Speaker 2: I had no idea, but I yelled downstairs to call 9-1-1, which he did.
• 17:54
  Speaker 2: Or it was just had a cold or he was like it was a drug related.
• 17:56
  Speaker 2: I had no idea, but I yelled downstairs to call nine one one, which he did.
• 17:58
  Speaker 2: But I knew that that baby was out in the next class.
• 17:59
  Speaker 2: So the baby head pops out and then the baby does not slither out.
• 18:03
  Speaker 2: And I was like, oh shit.
• 18:05
  Speaker 2: And I was like, okay, if I knew what I was doing, I would maneuver the baby and get the baby out.
• 18:13
  Speaker 2: I mean, I reached in and I could feel the shoulder behind the pubic bone.
• 18:16
  Speaker 2: So I thought to myself the best thing I could do is move mom, because that I could do.
• 18:21
  Speaker 2: And so I pulled her over on.
• 18:22
  Speaker 2: I told her I was like you need to get on all fours and she's like I can, like you can, and she was my size.
• 18:28
  Speaker 2: I just pulled her over and the baby popped out.
• 18:30
  Speaker 2: I later learned that that was called the Gaskin maneuver is pulling someone over to hands and knees, so I actually did something.
• 18:45
  Speaker 1: That was a maneuver for dislodging a, you know, a shoulder, wow.
• 18:49
  Speaker 2: So after that I was like I got to go become a midwife.
• 18:50
  Speaker 2: And then it was just a decision of whether I wanted to become a home birth midwife or a hospital birth midwife.
• 18:55
  Speaker 2: And for me, well, one.
• 18:58
  Speaker 2: I mean I'm old, and so the idea of being in someone's home for several days, I'm like can I really do that, like spend days in someone's home, I'm like I'm going to, I'm too old for that, not now.
• 19:11
  Speaker 2: I realized hospitals I could be on call for like 48 or even longer hours, but I guess I sort of feel like the work that needs to be done needs to be done in the hospital.
• 19:21
  Speaker 2: That's where birth needs to change.
• 19:23
  Speaker 2: So I can go do home births, but that's not going to change anything.
• 19:28
  Speaker 2: So, and yeah, to me it's about changing things.
• 19:34
  Speaker 1: So what does the education for that look like for you?
• 19:38
  Speaker 2: Well, I'm doing the nurse part first.
• 19:40
  Speaker 2: You have to become a nurse before you become a midwife.
• 19:42
  Speaker 2: So I applied to USM and UNE accelerated programs.
• 19:48
  Speaker 2: So there's 16 months and I got into both, so I'm going to UNE.
• 19:50
  Speaker 2: I got a scholarship, got into both, so I'm going to UN.
• 19:51
  Speaker 2: I got a scholarship to UNA, so I'm going to UNA because I think it's a better school and I start May, so I'll be done September.
• 19:59
  Speaker 2: You know, the following year I'd really like to go.
• 20:04
  Speaker 2: Where I like to go would be Yale has a nurse midwifery program.
• 20:08
  Speaker 2: You do the whole thing in three years.
• 20:10
  Speaker 2: But yeah, I'm not moving.
• 20:12
  Speaker 2: I might consider they are doing some more online programs.
• 20:17
  Speaker 2: So they said they might have an online program in 2025.
• 20:21
  Speaker 2: So maybe I'll do, you know, maybe I'll get lucky.
• 20:24
  Speaker 2: Otherwise, there's a bunch of online programs and that's what I'll have to do, like Frontier has one.
• 20:30
  Speaker 2: I have a list somewhere.
• 20:33
  Speaker 1: All right.
• 20:33
  Speaker 1: Well, thank you, melissa, for sharing your birth stories today and talking with me about your journey to midwifery.
• 20:39
  Speaker 2: Okay, Thank you, this was fun.
• 20:42
  Speaker 1: Before you go, I just want to remind you I have a ton of resources for pregnancy and birth.
• 20:48
  Speaker 1: If you're pregnant, whether you're a first-time mom or if this is your fifth baby, I want you to check out the show notes, because I have some free trainings and free downloads that you can sign up for, as well as the link to access my labor of love, a comprehensive, self-paced online childbirth education course.
• 21:06
  Speaker 1: I created this course specifically for moms who don't want to be told what to do, regardless of where you're birthing or who you're birthing with, and I'd honestly love to teach you everything that I know so that you can prepare for an autonomous birth experience and prepare to step into your role as the leader of your birth journey.
• 21:25
  Speaker 1: So click to the show notes, check out all of those links and, if you ever have any questions, feel free to DM me at my main birth over on Instagram.