Birth Choices: Interview with Home birth Midwife Marcy Tardio

Marcy Tardio, CNM, LM is a licensed home birth midwife in New York City, and has been practicing for over twenty-five years.  We recently got together to discuss the process of choosing a care provider for birth.

HH: Marcy, can you briefly explain the difference between an ObGyn (Obstetrician/Gynecologist) and a midwife?

Marcy:  An ObGyn is a medical doctor. They are skilled at surgery, and providing high-risk care, but often they do not have experience with what normal birth looks like. Midwives are experts in normal birth. Those who work in a hospital may have different responsibilities based on the type of practice they’re in—normal as well as high-risk.

HH: What advice would you give to families choosing between this range of options?

Marcy: Ultimately, I encourage them to research the varied birth possibilities. There are certain books and films I recommend—“Ina May’s Guide to Childbirth” by Ina May Gaskin, “The Business of Being Born” (film), “Orgasmic Birth” (film), and “Birth Day”(film). Then, I ask them to consider their own vision of how they would like to give birth. They must also consider what makes them feel safest. The biggest problem is that people do not know the questions to ask to get the answers they seek. I try to help them navigate the healthcare system, and their own ideas, when we first meet.

HH: Why would a family want to give birth at home instead of in a hospital?

Marcy: Often it is because they consider birth as a normal, healthy life event. They wish to keep it intimate, within the family, shared with select people who they feel will nurture and care for them. They have an innate trust in their bodies, and their ability to birth, and feel this life event belongs within the context of the family, rather than with the strangers they will meet in a hospital setting.

Hospitals may represent to them illness, a system where they no longer have a voice, where what is normal is thought to be a potential problem to be managed.  They feel they will lose any sense of power, or empowerment, as well as normalcy, when birthing in a large medical system. With the high cesarean section rate, they often feel less safe in hospitals, with doctors, rather than at home.

HH: Could you give a recommendation for how a family can choose the best care provider for themselves?

Marcy: First, it is always important to think carefully about what is wanted and believed. Discussing all of this with a partner is essential.

Secondly, it is important to do research and do it early.  Nothing should be assumed.  Many hospitals are starting to call their labor floors “Birth Centers.”  But, they do not mean the same things, and most people may not realize this.

Thirdly, it is important to interview the providers. Do they offer interviews? How are they at answering questions?  Are they always on-call?  And most importantly, make sure the covering practitioners share their similar philosophies.

HH:  I would like to thank Marcy for taking the time to share her knowledge and views with us.