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