Marcy Tardio, CNM, LM is a licensed homebirth midwife in New York City, and has been practicing for over twenty-five years. She and Hannah 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?
MT: 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 looks like.
HH: ObGyns and their skills are incredible and life saving, but research shows that these skills and thinking can often lead to rates of intervention that are higher than medically necessary in the births of healthy mothers who otherwise would have had normal births.
It is important to find out the ObGyn’s C-section and intervention (induction and augmentation) rates to be the most informed when choosing a care provider and birth team.
MT: 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?
MT: 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?
MT: 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: In my years as a doula and as a friend and a family member to many people who choose hospital births, I have also found that this can be switched. Some people feel safest in a hospital environment and this helps them to relax and have the best birth experience that they can have for themselves. It just really depends on how they educate themselves about their choices and options.
Hiring a doula can be a great option for someone looking to navigate the hospital birth system or is looking for extra support at a home birth.
MT: 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? Do their 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.
Also, another great recommendation for researching resources is Choices in Childbirth. There are local birth websites as well that might post statistics about local doctors or midwives.
Above all, research, soul searching, and getting on the same page with a partner, in order to find out what works best is necessary! After that, they can surround themselves with others who support their vision and birthing future.
You are powerful!