Monday, July 19, 2010

What IS Mother-Friendly Care?

I've been tossing this phrase, Mother-Friendly, around for months now, but I am beginning to realize that people have very different ideas of what constitutes true Mother-Friendly care, as defined by the Coalition for Improving Maternity Services (CIMS).

First, let me say that Mother-Friendly is short for the Mother-Friendly Childbirth Initiative (MFCI).  There are 10 steps, which I will address in this post.  They are very specific and some steps are harder to achieve than others.  Do not just assume that your care provider is Mother-Friendly.  Put them on the spot.  Ask them.  These steps are based on the evidence. 

A Mother-Friendly Care Provider, Hospital, Birth Center, or Home Birth Practice:

1.  Offers all birthing mothers access to a doula, or anyone else they wish to have at their birth.  She also has access to professional midwifery care.

2.  Provides their statistics to the public about all aspects of their birth care, including measures of interventions and outcomes.

3.  Is respectful and sensitive to the beliefs, values, and customs of the mother's ethnicity and religion.

4.  Provides the birthing woman with the freedom to walk, move about, and choose her positions during labor and birth and discourages the supine (flat on back) position.

5.  Has clearly defined policies and procedures for collaborating with the original caregiver during the perinatal period when transfer from one birth site to another is necessary.  They will also link the new mother and baby to appropriate community resources, including during and after the pregnancy and follow-up breastfeeding support.

6.  Does not routinely practice the following procedures that are unsupported by scientific evidence, including by not limited to the following:
* enemas
* IVs
* withholding food or water
* early rupture of membranes
* Electronic Fetal Monitoring (EFM)
* Induction rate of 10% or less
* episiotomy rate of 20% or less, with a goal of 5% or less
* total c-section rate of 10% or less in community hospitals and 15% or less in high-risk hospitals
* VBAC rate of 60% or more with a goal of 75% or more.

7.  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.

8.  Encourages all mothers and families, including those with sick or premature infants, to hold, touch, breastfeed, and care for their babies to the extent compatible with their conditions.

9.  Discourages non-religious circumcision of the newborn.

10. 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 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 teats or pacifiers to breastfeeding infants.
     10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from hospitals or clinics.

This is the criteria the members of the Tarrant County Birth Network support, believe in, and ultimately practice.  Next time someone says they are Mother-Friendly, you'll be able to know exactly what that means.  It's not just a catch-phrase - sure, no one is hostile towards mothers - but are they truly supporting these mothers and fathers in becoming a family?  Step number six is pretty intense and where a lot of care providers do not qualify for Mother-Friendly status.

Mother-Friendly status is what all care providers should be striving for.  Ask your care provider if he/she is Mother-Friendly and what they are doing to become Mother-Friendly.  This is the way we are going to change maternity care in the US.  This market is consumer driven, and you are the consumer.  Demand Mother-Friendly care. 

1 comment:

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