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I find myself on-line almost every day…I can’t help clicking on long, fascinating birth stories or natural empowering childbirth experiences. I fall into reading wonderful stories from real parents and I keep wondering why more hospitals/OB’s don’t follow the Mother-Friendly Childbirth Initiative? Although I believe many homebirth and birth centers follows this initiative, I can’t find any hospitals or OB’s that agree and follow the important steps of MFCI.

This is to provide evidence based care for mothers, babies and families…something feather mama highly believes in. There is even a book to help guide large practices and make it easy, but we still have nothing supporting our community in St. Petersburg Florida.

The Coalition for Improving Maternity Services (CIMS) has coined the phrase and here is their MISSION:
The Coalition for Improving Maternity Services (CIMS) is a coalition of individuals and national organizations with concern for the care and well being of mothers, babies, and families. Our mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs. This evidence-based mother-, baby-, and family-friendly model focuses on prevention and wellness as the alternatives to high-cost screening, diagnosis, and treatment programs.

Listed below are 10 steps that should be followed to be considered. Do not just assume that your care provider is Mother-Friendly. Always ask questions. Remember this is YOUR birth, not theirs.

Ten Steps of the Mother-Friendly Childbirth Initiative
For Mother-Friendly Hospitals, Birth Centers,* and Home Birth Services

To receive CIMS designation as “mother-friendly,” a hospital, birth center, or home birth service must carry out the above philosophical principles by fulfilling the Ten Steps of Mother-Friendly Care.

A mother-friendly hospital, birth center, or home birth service:

    1. Offers all birthing mothers:
      • 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 woman—for example, a doula,* or labor-support professional;
      • Access to professional midwifery care.
    2. Provides accurate descriptive and statistical information to the public about its practices and procedures for birth care, including measures of interventions and outcomes.
    3. Provides culturally competent care—that is, care that is sensitive and responsive to the specific beliefs, values, and customs of the mother’s ethnicity and religion.
    4. Provides the birthing woman with the freedom to walk, move about, and assume the positions of her choice during labor and birth (unless restriction is specifically required to correct a complication), and discourages the use of the lithotomy (flat on back with legs elevated) position.
    5. 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.
    6. Does not routinely employ practices and procedures that are unsupported by scientific evidence, including but not limited to the following:
      • shaving;
      • enemas;
      • IVs (intravenous drip);
      • withholding nourishment or water;
      • early rupture of membranes*;
      • electronic fetal monitoring;

other interventions are limited as follows:

    • Has an induction* rate of 10% or less;†
    • Has an episiotomy* rate of 20% or less, with a goal of 5% or less;
    • Has a total cesarean rate of 10% or less in community hospitals, and 15% or less in tertiary care (high-risk) hospitals;
    • Has a VBAC (vaginal birth after cesarean) rate of 60% or more with a goal of 75% or more.
  1. 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.
  2. 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.
  3. Discourages non-religious circumcision of the newborn.
  4. Strives to achieve the WHO-UNICEF “Ten Steps of the Baby-Friendly Hospital Initiative” to promote successful breastfeeding:
    1. Have a written breastfeeding policy that is routinely communicated to all health care staff;
    2. Train all health care staff in skills necessary to implement this policy;
    3. Inform all pregnant women about the benefits and management of breastfeeding;
    4. Help mothers initiate breastfeeding within a half-hour of birth;
    5. Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants;
    6. Give newborn infants no food or drink other than breast milk unless medically indicated;
    7. Practice rooming in: allow mothers and infants to remain together 24 hours a day;
    8. Encourage breastfeeding on demand;
    9. Give no artificial teat or pacifiers (also called dummies or soothers) to breastfeeding infants;
    10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from hospitals or clinics

* Glossary

Augmentation: Speeding up labor.
Birth Center: Free-standing maternity center.
Doula: A woman who gives continuous physical, emotional, and informational support during labor and birth—may also provide postpartum care in the home.
Episiotomy: Surgically cutting to widen the vaginal opening for birth.
Induction: Artificially starting labor.
Morbidity: Disease or injury.
Oxytocin: Synthetic form of oxytocin (a naturally occurring hormone) given intravenously to start or speed up labor.
Perinatal: Around the time of birth.
Rupture of Membranes: Breaking the “bag of waters.”

All care providers should be striving for a Mother-Friendly status, although not one local OB’s is following these care. Ask, ask and ask! Find out if your care provider is Mother-Friendly and what they are doing to become Mother-Friendly. It’s up to us to change maternity care in the US. This market is consumer driven, and you are the consumer. Demand it. You deserve it.

Our hope at feather mama is to make change and give evidence based information for mothers and families in our local community.

~Laura