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How to Become Mother-Friendly

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How to Become Mother-Friendly

SKU# 9780826129765

Policies & Procedures for Hospitals, Birth Centers, and Home Birth Services


  • Barbara Hotelling MSN, WHNP, LCCE, CD(DONA), CHT, IBCLC
  • Helen Gordon DNP, CNM, CNE
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This is the only book to present the evidence-based policies and procedures that medical and non-medical staff can use to develop Mother-Friendly Care in their facilities. The Mother-Friendly Childbirth Initiative (MFCI), developed by the Coalition for Improving Maternity Services (CIMS), is a wellness model designed to improve birth outcomes and substantially reduce costs. It is an evidence-based mother-, baby-, and family-friendly model that focuses on prevention and wellness as alternatives to high-cost screening, diagnosis, and treatment programs. The MFCI is the first and only consensus document on U.S. maternity care and is recognized as an important instrument for change in the U.S. and abroad.

The book is based on research and evidence developed by CIMS and includes 10 protocols, each with detailed policies and procedures and supporting information and resources that help implement the change to Mother-Friendly Care. Each protocol is authored and reviewed by recognized leaders in a variety of childbirth and maternity care arenas. The book traces the development of Mother-Friendly Care and describes its core tenets along with supporting statistical information. These tenets eschew practices not supported by scientific evidence. The manual includes implementation strategies for the evidence-based nursing care training programs of such organizations as Lamaze, ICEA, and AWHONN, and supports the WHO-Unicef "Ten Steps of the Baby-Friendly Hospital Initiative" to promote successful breastfeeding.

Key Features:

  • Provides evidence-based policies and procedures for developing Mother-Friendly Care in maternity care facilities
  • Presents specific guidelines that can be used as a standard to measure Mother-Friendliness and subsequently used for marketing purposes
  • Designed to provide childbirth educators and doulas with guidelines for promoting Mother-Friendly Care to birthing women
  • Assists nurses who want to promote more rapid change on their units toward Mother-Friendly Care
  • Supports the WHO-UNICEF "Ten Steps of the Baby-Friendly Hospital Initiative" to promote successful breastfeeding

Product Details 

  • Publication Date April 14, 2014
  • Page Count 184
  • Product Form Paperback / softback
  • ISBN 13 9780826129765
  • EISBN 9780826129772

Table of 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

  1. Mother-Friendly Childbirth Initiative Self-Assessment Tool 121


  2. Having a Baby? 10 Questions to Ask 127


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

    Barbara A. Hotelling

  4. Is Your Doula Practice Mother-Friendly? 137

    Barbara A. Hotelling

  5. Are Your Birth Classes Mother-Friendly? 139

    Barbara A. Hotelling

  6. Nitrous Oxide Use in the Intrapartum/Immediate Postpartum Period 141

    Laurey Munch

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

    Barbara A. Hotelling

  8. Care of Incarcerated Women in Labor 157

    Laura O. Houenou

Index 163

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