Houston, we have a problem.
While many countries around the world are seeing a decrease in maternal mortality, we are seeing an alarming increase in the United States.
The Mother Friendly Childbirth Initiative seeks to improve the health of mothers and babies holistically.
Baby Friendly and Mother Friendly Childbirth Initiatives can be confusing, and this causes the terms to be misused interchangeably. Here is a very simple explanation:
Policies that support breastfeeding and mother/baby bond (link here)
Policies that support the normalcy of birth, the empowerment of women during pregnancy and birth, a woman’s autonomy, doing no harm, and responsibility in each sphere of care.
The Mother-Friendly Childbirth Initiative is an initiative of the Coalition for Improving Maternity Services. It’s goals are broader, encompassing the baby friendly goals and promoting evidence based maternity care. While there is no Mother Friendly Childbirth designation as there is with Baby Friendly, there are specific goals.
The Coalition for Improving Maternity Services’ ten steps must be fulfilled to accomplish the Mother Friendly Childbirth goals:
- Offers all birthing women:
Unrestricted access to the birth companions of her choice, including fathers, partners, children, family members and friends;
Unrestricted access to continuous emotional and physical support from a skilled doula or labor support professional;
Access to professional midwifery care.
- Provides accurate descriptive and statistical information to the public about its practices and procedures for birth care, including measures of interventions and outcomes.
- Provides culturally competent care that is sensitive and responsive to the specific beliefs, values and customs of each birthing woman’s ethnicity and religion.
- Provides the birthing woman with the freedom to walk, move about, and assume the positions of her choice during labor and birth–unless the restriction is specifically required to correct a complication–and discourages the use of the lithotomy (flat on back with legs elevated) as a birthing position.
- Has clearly defined policies and procedures for:
Collaborating and consulting throughout the perinatal period with other maternity services, including communicating with the original caregiver when transfer from one birth site to another is necessary;
Linking the mother and baby to appropriate community resources, including prenatal and post-discharge follow-up and breastfeeding support.
- Does not routinely employ policies, practices and procedures that are unsupported by scientific evidence, including, but not limited to the following:
IVs (intravenous drip);
withholding nourishment or water;
Artificial Rupture of Membranes (AROM);
Electronic Fetal Monitoring;
Other interventions are limited as follows:
An induction rate of 10% or less;
An episiotomy rate of 20% or less, with a goal of 5% or less;
An overall cesarean rate of 10% or less in community hospitals and 15% or less in tertiary care (high-risk) hospitals;
Vaginal Birth After Cesarean (VBAC) rate of 60% or more, with a goal of 75% or more.
- Educates staff in non-drug methods of pain relief and does not promote the use of analgesic or anesthetic drugs not specifically required to correct a complication.
- Encourages all mothers and families–including those with sick or premature newborns or infants with congenital problems–to touch, hold, breastfeed and care for their babies to the extent compatible with their conditions.
- Discourages circumcision of the newborn.
- Strives to achieve the WHO-UNICEF “Ten Steps of the Baby-Friendly Hospital Initiative” to promote successful breastfeeding.
While all of these goals may not be the individual choice of each mother, each goal does validate the mother’s individual choices.
We have worked with care providers who exemplify these goals. Our desire is this kind of care become normal for all mothers and that we do our part as supporters of mothers to help facilitate these goals one mother at a time.
To learn more about the Mother Friendly Childbirth Initiative, visit here.
You may find the first part of this series on Baby Friendly here.