My Maine Birth - Mid-Week Midwife edition - from Doula to Midwife - featuring Melissa Tomback

MyMaine Birth: Mid-week midwife edition - from Doula to Midwife featuring Melissa Tomback

You're tuning in to the mid-week midwife edition of MyMaine Birth. In these episodes we explore the world of childbirth, pregnancy, and motherhood from the perspective of midwives in the great state of Maine. We will delve into the latest research, share personal stories and experiences, and connect with experts in the field to bring you the most up-to-date and reliable information. Whether you are a soon to be mom, a seasoned mother, or simply interested in the world of birth and midwifery, these episodes are for you.

Todays guest is Melissa Tomback and we will hear her share about her experience birthing her daughter in a hospital and her son at home. Melissa has been a doula in Maine for 10 years now. She helped to create the Community Doula Birth Program, a non-profit organization that provides reduced cost Doula services to low income families. The program also mentors new Doulas and helps them to obtain their certifying births.

Melissa also share about the experience that lead her to make the decision to pursue midwifery, why she chose the certified Nurse Midwife path, and a little bit about what that journey will look like for her.

You can find the Community Doula Birth Program at https://www.communitydoulas.org

If you or someone you know is expecting and would like to capture the precious moments of meeting your baby for the first time, I highly recommend considering my Portland Maine birth photography services. I am a professional Portland Maine Birth photographer and I specialize in documenting the beauty and emotion of birth. I also provide families with a treasured keepsake to cherish for years to come - I create a personalized and intimate photo album with every Birth Story I document.

Join us and listen here to my conversation with Melissa. Scroll down for the full transcript.

Angela: Hi Melissa, welcome to MyMaine Birth

Melissa: Hey!

Angela: So to get started will you tell me a little bit about when you found out you were pregnant and the care that you chose?

Melissa: We decided on January 1st that we would try having a kid, and I was pregnant on January 4th. So I was pregnant that month. And we were living in Cambridge, Massachusetts. And we ended up buying a house in Wayland Massachusetts during my pregnancy - we already lived there when Talia was born. So the doctor I had - I don't remember her name - I remember the doctor who delivered Talia, but I don’t remember her name. In retrospect, she was just a typical traditional doctor. I was completely healthy, I had absolutely nothing wrong the entire pregnancy. I worked, I was a lawyer - I was a criminal defense attorney, I was working during pregnancy - I had no morning sickness. I was happy, I was in a great mood when I was pregnant. I would be pregnant again today if I could, but that’s not possible.

I chose hospital care because I really knew nothing about birth - like most women I think going into birth. We aren’t really taught anything. So you go to the hospital to have a baby, right? My ex worked at Massachusetts General Hospital so we just picked a doctor there. What I do remember about the woman was that she was a black woman - so I picked her mainly based on that, she was really highly educated, she seemed really smart - and I thought that was someone who was a little more outside of the box maybe - but she wasn’t. So then Talia’s birth was - well she came very early. Well not very, but 2 1/2 weeks early - early enough that I wasn’t expecting her to come. I was actually at the mall, and I have no idea what I was doing but my water broke and it was not like a little trickle - it was everything. I went to the gap and I bought clothing because I was soaked. I did call the doctor and they were like - you have to come in. And at the time my husband was in New York speaking - and like made an announcement - I have to go my wife’s water just broke. So he took a plane home, and I think we finally went in at like midnight or close to midnight 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 nothing. And they immediately wanted to induce me, but back then induction looked a little different - they literally start with Pitocin, like they don’t do any cervical ripening. And for whatever reason, because I knew nothing - I said no! And I don’t know why I said No, I mean I was having contractions by then but nothing major. 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 really had changed, I was having contractions but not really anything - I mean at the time I didn’t know that - but looking back, nothing that would have dilated me or gotten me anywhere. And for whatever reason, I intuitively said - well it doesn’t seem to make sense for you to stick your hands inside me, my water has broken - won’t that increase the chance of infection? And she was like - yeah. And I said - oh let me guess, your going off your shift and you want to put a note in your chart - well put a note in your chart that says I don’t want to be checked. And then she left. And then Dr. Blatman came in later - who was the one who delivered Talia - and said I heard that you don’t want to be induced - I’m not going to check you because I don’t want to increase the chance of infection. And he left me, but the other thing that was happening - was I wasn’t allowed to eat. Because this was back, I mean Talia is 25, so it’s not that long ago that you couldn’t eat during labor in the hospital. But the nurses were 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. So we left the hospital in the middle the day and went down to Charles Street and I think we went to Rebecca’s or something - I got some soup. But I’m having contractions - like now they are every 10 minutes, now they are getting closer. I am sort of keeling over on the sidewalk. We got something to eat, we went back - and eventually at some point I finally said - fine, induce me. I was having contractions but never got into a great pattern, but when they gave me that Pitocin - back then they did not start it at like a 2 and titrate it up slowly - they started much higher. And when that Pitocin hit me, I was done - I was like, you have got to be kidding me - I was like, give me an epidural. So I had an epidural, I remember taking a nap - it wasn’t that long afterwards that I was fully dilated - she was born at around 9:45 at night. I pushed her out in about 45 minutes, and she was actually posterior, which explains why her contractions never got in a god pattern. And yeah, so I pushed her out in 45 minutes, they placed her on my chest - and she pooped all over me. And that was Talia’s birth. They cleaned me off, and I remember nursing on the other side that she hadn’t pooped on. And as a hospital birth goes, it was fine. I mean, it wasn’t - some people describe their births as awful and the hospital was not good - the hospital was fine - but what I hated about it 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 whenever I took antibiotics I would get a yeast infection. So a day or two after when I was in the hospital - I was like, I have a yeast infection. And the doctor was like, no it’s just the aftermath of the birth. And I was like, no you gave me intravenous antibiotics - and I know what a yeast infection feels like, this is a yeast infection. Not only that but Talias mouth was filled with thrush - so it took 2-3 months to get rid of the yeast. It must have been resistant. They gave me all sorts of stuff and nothing works. Eventually I just used Ginger Violet which is an old midwifery, old ancient herb that people use that there is controversy over it - I finally just used it and within two days it was gone. And it wasn’t then that I said oh next time I’m going to birth at home - because I didn’t even know that you could birth at home. So I started hanging out at a Waldorf school, and everybody at Waldorf they all give birth at home. So that is how I ended up there. So then Jacob I was for sure, not going back to the hospital. I did have one complication with Talia, I had a blood incompatibility with my ex, and she had Coombs - or I had Coombs, I’m not sure if its the baby or if its me - but enough that the baby’s body was fighting that so it didn’t fight bilirubin so her bilirubin shot really high the first day. So she ended up under lights. And I knew that I had like an 85% chance that would happen again with my second. So I had a light table at home in case that happened again, and in fact it did happen again - we used the light table. But I actually ended up back in the hospital again with Jacob because of high bilirubin the doctor sent me in. So I did have a home birth - but the next day I was in the hospital.

So the home birth, there was nothing to tell. I started labor around 6pm, the midwife got there around maybe midnight. I yelled at her that I had made a mistake, I needed to go to the hospital, I needed drugs - there was no way I was doing this. And she’s like, well let me check you - and you know, she’s taking her time. And she checked me and she was like, you're not going to make it to the hospital, you're about ready to push. And I was like, oh - ok sure, I can do this - and I pushed twice and he was out, that was it. The first time I pushed it was like, I was crowning and it killed, and I was like oh my gosh I have got to get this over with - so I just pushed with all my might and he was out. But then I had a visiting doctor come and she got scared with his bilirubin numbers and so she sent me into the hospital the next day. He was born at 2 in the morning, so I think the following night we were in the hospital. They put him under the lights which was exactly what I would have done at home. They did nothing more for him. For Talia they had given her an IV so she would flush out and pee out the bilirubin - they didn’t do that, I was at Newton-Wesley. And the next morning the numbers had gone down and the doctor was like - what is this baby doing here. And I was like - you have got to be kidding me, so we left and that was the end of that. So it was one night, it wasn’t awful but what was hard was that I didn’t have a room because I was not a patient so we were literally in the hall - which is crazy.

Angela: So that is pretty crazy. So your water broke in the mall with Talia and the nurses were definitely advocating for you to be like - go get a sandwich.

Melissa: It doesn’t seem like it was that long ago that we couldn’t eat in labor and things change.

Angela: So when did you move to Maine?

Melissa: 2012, we were living in Newton, Massachuetts. And I grew up in New York and Newton was just like that, all obsessed with money and cars and wealth. And my son was becoming driven by that by then, with all that - so we were like we have got to get out of here - so we moved to Maine. But he’s still obsessed with all that stuff, so it didn’t change. My daughter is the opposite - she is much more save the world personality, and he is much more - take over the world personality.

Angela: Oh my gosh, so what lead you to take your doula training?

Melissa: Well it was Talia who said to me - Mom, you should go do something with Moms and babies - because I used to go up to all these women who were pregnant and I would give them my lactation consultant’s number - I still remember, Dot Norcross 617-244-5593. I know her number by heart. If it had not had been for Dot, I would not have been nursing. In fact when we moved, the people who bought our house were pregnant and I gave them her number and they emailed me and said had they not had Dot they would not have been nursing. So when I saw the Doula training I said - oh I should go check that out. So I did it and it was 2013, I think it was 2015 when we founded the Community Doula Birth Program. So it wasn’t my initial idea, I would say it was probably Rebecca Goodwin’s initial idea. She still is on the board, and she had gotten a little bit of money from somebody who was interested in starting this, but nothing really happened until Julie Version got herself a grant and 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. And so there were like four of us, maybe five in the beginning. And we essentially just traded stuff - like Rebecca is a massage therapist so she traded massages to get a logo made for us. And Julie did a birth and got the website set up. As a lawyer I set the corporation up, I made us a 501c3. so we all sort of did stuff. The fact that it still exists today, to me, is mind boggling. But we always seem to have just enough, I mean we got one grant - but we haven’t gotten any money since. And the way we survive is we service people who have money and they pay us, and then we have money to serve the people who don’t have money.

Angela: So the Community Doula Birth Program serves low income families and the program also mentors new doulas and helps them obtain their certifying births for them to become a certified doula?

Melissa: Right, and some of our doulas we have had from the start, most of our doulas - some of them go on to become midwives or they move or whatever. But I would say that a lot of our doulas realize that certification is relatively meaningless and don’t even bother.

Angela: Right because anyone can create a doula training certification program.

Melissa: Right it’s meaningless, it’s not like - you know when I was a lawyer, we all took the bar. It’s not like that, it’s not like the medical board. It’s a certification that has no standardization - you don’t know what that means when someone is certified. I had a repeat client that was birthing in New Hampshire and the hospital required me to be certified during covid - which makes no sense, it’s not like that helps protect anybody from covid. But I went and got cross certified from Pro Doula - I essentially paid money and now I am certified for life - I took a test and that was it.

Angela: Alright, so what made you decide to become a midwife?

Melissa: So last year, on mothers day - I had been doing some work at crossroads which is a treatment facility for substance addicted women. And there was a woman there who was due but she had been discharged, and I gave her the card for the program. So she texts me at like 3am, and I called her in the morning and she was like I really need help, will you come over? So I was like - I’m not going to say no - so I went over, and I fortunately had a bag of gloves in the car from covid - because this was still last year, covid was still real. And just from the sound I could tell she was clearly pushing during contractions. So I was like, let me check you - and I checked her and the baby head was right there. And I was like oh crap, the baby is coming on the next push - it wasn’t her first baby. And there was some guy downstairs who was sick, he was like throwing up - I don’t know if he was throwing up from covid or if he just had a cold or if it was drug related - but I yelled downstairs for him to call 911 - which he did - but I knew that baby was out on the next push. So the baby’s head pops out and then the baby does not slither out - and I was like oh, shit. And I was like, ok if I knew what I was doing I would maneuver the baby and get the baby out - I mean I reached in and I could feel the shoulder behind the pubic bone - and so I thought the best thing that I could do was to move the mother, because that I could do. And I told her, you need to get on all fours - and she was like, I can’t - and I was like, yes you can - and she was my size, I just pulled her over and the baby popped out. I actually later learned that was called the gaskin maneuver, was pulling someone over to their hands and knees and I actually did something that was a maneuver for dislodging a shoulder.

Angela: Wow, so after that..

Melissa: I was like, I’ve got to go become a midwife! And then it was just a decision of did I want to become a home birth midwife, or a hospital midwife. For me, I am old, so the idea of being in someones home for several days - I was like, can I really do that? I think I’m too old for that. I know that hospitals I could be on call for up to 48 hours at a time. But I guess I sort of feel like the work that needs to be done, needs to be in a hospital. That is where birth needs to change. So I can go and do home births - but that isn’t going to change anything. To me it’s about changing things.

Angela: So what does the education look like for that?

Melissa: Well I’m doing the nurse part first - you have to become a nurse before you can become a midwife. I got a scholarship to UNE to the accelerated program which will take 16 months. So I start in May and I will be done in September the following year. Where I would really like to go would be Yale - they have a nurse midwifery program and you can do the whole thing in 3 years. But yeah, I’m not moving. They said they might have an online program in 2025, so maybe I will get lucky. But otherwise there is a bunch of online programs and that is what I will have to do - like Frontier has one, I have a list.

Angela: Well thank you Melissa for sharing your birth story today and about your journey to midwifery.

Melissa: ok, thank you - this was fun! Bye.

And thats the end of another MyMaine Birth Podcast! Thank you for joining me. I hope the stories shared here have been informative and inspiring for all of my listeners.

If you are looking to document your own birth story, I highly recommend considering my Portland Maine Birth Photography services. I am a skilled Portland Maine Birth Photographer and am very passionate about capturing the raw and emotional moments of the birthing process. I also design a personalized and intimate photo album, creating a lasting and beautiful memory of one of the most special moments of your life. For more information on Birth Photography in Portland Maine head over to https://www.mymainephoto.com/birthphotography and schedule a complimentary zoom consultation with me.

Thank you for tuning in and I look forward to bringing you more amazing birth stories. Don’t forget to subscribe and leave a review! And I will see you back here again next week!