How to Become Mother-Friendly

Barbara Hotelling, MSN, WHNP-BC, LCCE, CD(DONA), IBCLC, is an internationally renowned Women's Health Nurse Practitioner and Consultant and on the staff of the University of North Carolina, Chapel Hill, Department of Family Medicine. An informed and passionate champion of Women's Health, particularly as it relates to the birthing experience, she is a founding member and principal in CIMS (Coalition for Improving Maternity Services) where she serves as Co-Chair, CIMS Leadership Team and Chair, CIMS Evidence and Action Committee. She has spent the past few decades serving families with childbirth education, birth doula support and lactation support. She has served the birth advocate national efforts as President of DONA and Lamaze. She currently teaches Lamaze classes at UNC Women's Hospital, Chapel Hill and trains doulas and childbirth educators internationally.

Contents









Contributors xi




Foreword by Wendy C. Budin, PhD, RN-BC, FAAN xiii




Preface xv










Step 1: A mother-friendly hospital, birth center, or home birth service offers all birthing mothers unrestricted access to birth companions, labor
support, and professional midwifery care. 1





Marilyn Curl




Policy 1A: Unrestricted Access to Birth Companions 3




Policy 1B: Access to Continuous Emotional and Physical Support by a Skilled Woman 5




Policy 1C: Unrestricted Access to Midwifery Care in All Birth Settings 7










Step 2: A mother-friendly hospital, birth center, or home birth service provides accurate descriptive and statistical information to the public about
the practices and procedures for birth, including measures of interventions and outcomes. 15





Marilyn Curl




Policy 2: Provides Accurate and Descriptive and Statistical Information About Birth Care Practices 17










Step 3: A mother-friendly hospital, birth center, or home birth service 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. 19





Karen Miles Sheffield




Policy 3: Culturally Competent Care 21










Step 4: A mother-friendly hospital, birth center, or home birth service 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. 25





Laurey Munch




Policy 4A: Freedom of Movement 27




Policy 4B: Discourage the Use of the Lithotomy Position





Step 5: A mother-friendly hospital, birth center, or home birth service has clearly defined policies and procedures for collaborating and consulting
with other maternity services and linking the mother and baby to appropriate community resources during both the prenatal and the postpartum periods. 33





Judith A. Lothian




Policy 5A: Collaborative Care 35




Policy 5B: Community Resources 37




Policy 5C: Transfer of the Midwife-Attended Planned Home Birth Patient to the Hospital Maternity Service 38





Step 6: A mother-friendly hospital, birth center, or home birth service does not routinely employ practices and procedures that are unsupported by
scientific evidence. 41





Barbara A. Hotelling




Policy 6A: Shaving Practices 43




Policy 6B: Enema Practices 44




Policy 6C: Intravenous (IV) Drips 45




Policy 6D: Withholding Nourishment or Water 47




Policy 6E: Early Rupture of Membranes 49




Policy 6F: Electronic Fetal Monitoring 50




Policy 6G: Induction 53




Policy 6H: Episiotomy 56




Policy 6I: Cesarean Surgery 58




Policy 6J: Vaginal Birth After Cesarean 61










Step 7: A mother-friendly hospital, birth center, or home birth service educates staff in nondrug methods of pain relief, and does not promote the use
of analgesic or anesthetic drugs not specifically required to correct a complication. 79





Jeannette Schwartz




Policy 7: Pain Management and the Laboring Woman 81










Step 8: A mother-friendly hospital, birth center, or home birth service 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. 85





Rhonda Lanning




Policy 8: Mother-Friendly Care of the Sick Newborn 87









Step 9: A mother-friendly hospital, birth center, or home birth service discourages nonreligious circumcision of the newborn. 91




Catherine Gordon




Policy 9: Discourage the Routine Circumcision of Newborn Males for Nonreligious Reasons 93










Step 10: A mother-friendly hospital, birth center, or home birth service strives to achieve the WHO-UNICEF Baby-Friendly Hospital Initiative to
promote successful breastfeeding. 97





Eileen A. DiFrisco and Jessica Deeb




Policy 10: Management 99









Appendices 119








Mother-Friendly Childbirth Initiative Self-Assessment Tool 121




CIMS







Having a Baby? 10 Questions to Ask 127




CIMS







Is Your Perinatal Practice Mother-Friendly? A Strategy for Improving Maternity 131




Barbara A. Hotelling







Is Your Doula Practice Mother-Friendly? 137




Barbara A. Hotelling







Are Your Birth Classes Mother-Friendly? 139




Barbara A. Hotelling







Nitrous Oxide Use in the Intrapartum/Immediate Postpartum Period 141




Laurey Munch







Birth Can Safely Take Place at Home and in Birthing Center 149




Barbara A. Hotelling







Care of Incarcerated Women in Labor 157




Laura O. Houenou








Index 163