Job Spotlight: Nicole Taylor, nurse midwife at Trinity Center for Women

When speaking with patients, Nicole Taylor often shares a personal story that was the genesis of her decision to leave the banking world for that as a labor and delivery nurse.

She and her husband, Jamie, were residing in Peachtree City, Ga., in the Atlanta area nearly two decades ago when she suffered dual tragedies. One was the loss of a baby she had carried for 37 weeks. The other was a Christmas holiday car crash that left her with a fractured vertebrae and pelvic bone.

"After those two experiences, my husband and I decided we needed a whole change of scenery, just a big change in our lives," said Taylor, a native of College Park, Ga.

Thus the couple, with son, Brent, made the decision to relocate to the Columbus area in 2000. She remained in banking, on the front lines as a teller, but began searching for meaning in her life and praying about it.

That led to a middle-of-the night awakening in which she told her husband of her desire to become a nurse, and not just that, but one who helps deliver babies.

"He thought I had lost my mind," Taylor said. "He was like: You can't even stand to have a shot. You can't stand the sight of blood. And knowing what we've just been through, how are you going to be able to do that?"

Taylor explained to him it was simply just what she felt compelled to do.

That resolve set the stage for her to return to school, working toward a bachelor's of science degree in nursing at Columbus State University in 2005. After graduating, she became a pediatric nurse at The Medical Center, but quickly moved into labor and delivery at Doctors Hospital in 2006, working there while observing a little known group of women tending to their own patients in a more holistic way.

That prompted Taylor to return to school via online classes with Frontier School of Midwifery and Family Nursing, earning a master's degree in that specialty about 18 months ago.

She had become a certified nurse midwife, with all of the stars lining up for her to join the midwifery practice at the Trinity Center for Women on Warm Springs Road. She's one of four midwives at the center, which was launched by St. Francis Hospital in 2009 and is staffed with board-certified OB/GYN physicians from both OB/GYN Associates and OB/GYN Physician Partners.

Taylor, now 46, said she has found her calling in an occupation that allows her to make a huge, personalized impact on the lives of women and their families. At its core, she said, it takes true passion to do it.

"Basically, life experience is what led me to where I am today," she said.

The Ledger-Enquirer visited with Taylor recently to discuss her job, why she enjoys and the emotional peaks and valleys that come with it. This interview is edited for length and clarity.

Did you research nursing before you made the big leap from the banking career?

Not really. I knew that you could make pretty decent money as a nurse. I did not know all the different types of nursing (specialties) out there. ... But getting into it, I knew I wanted to deal with moms and babies just from what I had been through. It was just kind of an awakening. I know that sounds kind of crazy.

But I will tell you that labor and delivery nursing, out of all the different types of nursing, is a joyous occasion for the most part. Of course, there are women who go through bad experiences. So I really feel a special bond and a special blessing to be able to take care of women that go through that because I've been through so many things myself.

Describe your decision to become a midwife?

I worked alongside them (at Doctors Hospital), but I was their nurse, taking care of their patients. So I was in a different role when I first kind of started loving midwifery (pronounced mid-wif-uh-ree), watching what they do and how they take care of patients. I just loved watching it from the provider side. It kind of gave me the motivation to say, I want to do that.

What did you like about it? It seems very emotional.

There is an emotional connection. Midwives are very big on the holistic approach to health care. There's a lot more one on one and hands-on. There's a lot of interaction between the patient and a midwife.

It's a lot about what the wishes are of a woman surrounding the birth. So there's a lot going on: Do you want pain medicine or not? What kind of support people are you going to have in the room? There's a lot of dialogue about that.

We have a lot of patients that want epidurals. We have a lot of patients that want to be able to walk the halls and do some birthing techniques to help cope with the pains of labor. So we encourage that. There's just a lot of choices with midwifery care.

You start seeing patients when they consider pregnancy?

Yes. But we actually don't just deliver babies. We deal with any type of women's health need. So we do exams. We do STD screenings and testing. We can do pelvic exams.

We do see women for pre-conception care. If anyone's contemplating that, we can talk to them about nutrition, diet and exercise and how to have a really healthy pregnancy before they even start.

Then once these girls do come back and are pregnant, we see them from the beginning of their pregnancy until after delivery, and hopefully for years to come after establishing a relationship.

It seems you're just a step down from a full-fledged doctor?

Pretty much. Yes, we can do most things that physicians do. We're not surgeons, so that's not in our practice. If anybody did end up having to have a C-section scheduled (because of an emergency), we would not perform that. But if it's our patients, we would be with the physicians in the (operating room) right alongside the bed with them and providing support.

During a Caesarean section, what are you doing?

We're actually a surgical tech and we're first assist, so we're up there helping the physician with the actual surgery. They're doing the incisions, but we're helping with the instruments. It's basically the same concept as a surgical tech.

They don't need us in there because they have surgical staff. But we want to be with our patients to support them. And it means a lot to our patients.

How many office visits do you have with patients when they are going through a pregnancy?

It's about 14 visits total if they start their care early. We like to see patients starting when they're 7 or 8 weeks pregnant.

Do you ultimately develop bonds with them?

Yes, absolutely. Melissa, who's one of the midwives in our group who's been here the longest, she has patients where she's delivered every one of their babies. It can be three, four or five babies. Or she's seen the daughter of a patient who might be a teenager looking for contraception; she delivered that teenager years ago with her mother.

We see girls basically as soon as they start their periods .. and we can see them all of the way up to menopause. Our practice has a huge population of reproductive health patients, so we are quite busy with that. Patients who are my age, in their 40s going through perimenopause and menopause and those types of things, usually we refer them to our physicians.

At any given time, how many patients are you a midwife for?

As far as deliveries (as a group), we have an average every month between 40 and 50 patients who we deliver babies, and during our day we see a gamut of those pregnant women who need their visits, as well as patients that are getting their annual exams, the problem visits, and anything gynecological that needs to be seen.

What is done during a typical visit?

We see a lot of OB visits, women who are pregnant. That's the bulk of our day. Normally a quick visit will be listening to the baby's heart, checking measurements of their pregnancy, educating them. It depends on where they are in their pregnancy. And then we do have our annual exams, kind of a head-to-toe assessment of them.

Why choose midwives over a typical doctor?

What makes us stand out? Because we do have a more hands-on approach. When they walk in, more times than not they're going to feel like they've known us for more than 10 minutes. We do a lot of education. We want their input with what they want for their birth experience.

They may have had a baby before, but didn't have a lot of dialogue going on (with doctors and nurses), and they just notice the difference. A lot of our business is referral business. We do some marketing and a little bit of advertising, but not a lot.

What are misconceptions people have about midwives?

A lot of people think midwives just do home births. We don't, not in this community. Regulations and laws are different for each state. We are certified nurse midwives, so we have a nursing background ... For certified nurse midwives in Georgia, most of them you'll see in hospitals.

Other misconceptions?

We definitely will let girls have pain medications if they want it. I think people automatically think we make them have natural labor. We don't do that. There's definitely many choices and options out there. And, no, we don't deliver in the woods or rivers.

Do you do water births?

We have done water births in the past. People in our group have ... But there's guidelines for that, and there's not been a lot of studies with that and about safety. So ACOG, which is the American College of Obstetricians and Gynecologists, doesn't recommend birthing in the water. So we don't do water births.

However, we do let women labor in the water (and take them out when it's time to birth). So that's an option. Water actually helps with pain. Warm water on the belly and back is soothing and just the buoyancy in the water really helps. It's definitely something that's requested quite a bit.

You're a St. Francis center. Do you do all deliveries there?

I would say the majority of our deliveries are low risk, so we encourage those patients to go to a low-risk facility like St. Francis or Doctors Hospital (which has stopped doing baby deliveries).

But some women just feel more comfortable being near a (neonatal intensive care unit) like the one at Midtown Medical Center. They want to know that it's there if they need it. And that's what we're about is options, that a woman gets the birth experience that she desires.

... Patients under 37 weeks (pre-term labor) are automatically referred to Midtown Medical Center.

Another misconception is there are no male midwives?

There are men in midwifery, and they're also called certified nurse midwives. I don't know if there are any practicing male midwives in Georgia. There are some nationally, yes. I've been to conferences where there's actually been men sitting beside me and it's bizarre and I haven't been able to talk them, but one day I would like to do that.

Does insurance cover midwives?

Yes. And this Trinity Center is a mission pretty much for St. Francis hospital, so we see a large Medicaid population.

How do you relieve pain without medication?

Water and we do massage. I haven't taken official courses in massage, but I have massaged women's feet and their back. If a mom's got a support person, whether it be a husband or father of the baby or a family member, we encourage that person to be at the bedside and that helps.

So there's water labor, walking, anything but being flat on a bed. We encourage walking. We encourage working with exercise balls. It's basically being on the move. That's a goal with women who want unmedicated birth.

And it's also about what women are comfortable with. Some women don't want to be touched when they're in labor. And some women don't know that's what they want or don't want until they're in the heat of the process. We find out real quickly what women want and don't want.

What is the most challenging aspect about your job? Is it the process of going through a pregnancy and then problems occurring?

I would say that would be it. We have women who come in who have taken the home pregnancy test and they come in for their first weekly visit and there's no heartbeat. We're bursting their bubble with the very first visit. It's so difficult. And then we have moms who a pregnancy for them is not always going to be a good outcome; and that's statistically since the beginning of time. We have women come in just at different times of the pregnancy where we have to give them bad news about that ultrasound, that things are just not developing like they should. And then the horrible things are at the very end, when for no reason at all, the mother doesn't deliver a living baby. Sometimes it can be explained as soon as the baby's born ... and other times we just don't know. That's pretty devastating, especially for people who need resolution on what happened. We just can't give them those answers.

Do you shed some tears at times?

I shed tears all of the time. I could probably start crying as we sit here talking about this. We're all emotional creatures.

But I don't think anybody that gets into midwifery just does it for the money. I don't know how you can do midwifery and not have a passion for it. You're on call. There's a lot of time away from your family.

There's a lot of time with these women. You bond and get close with them. They even have our personal cell phone number and are calling us constantly.

So it's a huge commitment. I would definitely say you have to have a passion for it.

What's the most rewarding aspect of your job?

Just the miracle of birth, just when that baby's coming out.

It never gets old?

I don't feel like it does. Even when I was in labor and delivery nursing before, I watched babies come out for years and it's just awesome to watch family's faces when that happens. It's just a joyous, happy part of nursing, normally.

How many babies have you delivered?

Let's see ... as a midwife. I don't even have a number, but probably close to 200ish. I've been in it a year and a half.

What keeps you going through the long hours and the emotional ups and downs?

It just doesn't get old to me yet. I'm just getting started.

Ask you in five years?

Yeah (laughs)

Finally, what advice do you have for someone considering your profession?

I always get amazed when I talk to people, even some of the girls I went to school with for midwifery, that they didn't have any labor and delivery experience before they got into it. So they're nervous.

They've all been nurses, but some of them have done different things. They might have worked in a surgery center or worked in geriatrics or some other area.

There are so many factors in labor delivery, and I think there's just an intuition that you build, watching a woman going into labor, knowing the transition of when the baby is going to come out. So I personally feel like you need some of that labor and delivery nursing background.

And, then, just to really think about the commitment ... Where I was in my life going back to school, especially the age, I was in my 40s. But I didn't have grandchildren yet. My son was gone (to college). So it was the perfect time to dive into this. Had I had grandchildren or that type of thing, I probably would have had to re-evaluate everything.

So just make sure about the time commitment, because it is a lot.

This story was originally published October 25, 2014 at 3:49 PM with the headline "Job Spotlight: Nicole Taylor, nurse midwife at Trinity Center for Women."