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Part Two-The Ten Steps to being a Mother-Friendly Hospital


© Maurenne Griese

To receive CIMS designation as "mother-friendly," a hospital, birth center, or home birth service must carry out our 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; •early rupture of membranes; •electronic fetal monitoring;

other interventions are limited as follows:

•Has an oxytocin use rate of 10% or less for induction and augmentation; •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.

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 newborns or infants with congenital problems, to touch, hold, 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:

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The copyright of the article Part Two-The Ten Steps to being a Mother-Friendly Hospital in Pregnancy & Childbirth is owned by Maurenne Griese. Permission to republish Part Two-The Ten Steps to being a Mother-Friendly Hospital in print or online must be granted by the author in writing.

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Here's the follow-up discussion on this article: View all related messages

2.   Aug 28, 1999 2:02 PM
Ann makes a good point. Pacifiers have been demonstrated in the medical literature to have a negative effect on breastfeeding and milk supply. When babies are learning to nurse, they really need to ...

-- posted by Maurenne


1.   Aug 12, 1999 5:09 PM
The hospital my daughter was born at, 6 weeks early, seemed reasonably mother-friendly to me considering the circumstances. The mother-friendliest thing they did was allow me to stay there and receiv ...

-- posted by Ann_Gibson





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