Re: [ozmidwifery] Fw:Mother Friendly Childbirth Initiative

Helen and Graham Tue, 22 Mar 2005 21:33:03 -0800

Hi Kerreen

As per my earlier email I love the idea as being a concrete platform on which to develop policy. I also like the fact that the initiative is woman focussed and not midwife/health professional focussed as once the parameters are set into place, the assessor evaluating the health care facility doesn't have to be a health professional. This helps to keeps the whole thing objective and independent. I think it works pretty well with the Baby Friendly Hospital Initiative (BFHI). I'd love to see it happen, given the success of the BFHI and think MC would be the best placed to develop it and oversee it.

Helen Cahill

----- Original Message ----- From: "Kerreen Reiger" <[EMAIL PROTECTED]> To: <[email protected]> Sent: Wednesday, March 23, 2005 2:00 PM Subject: RE: [ozmidwifery] Fw:Mother Friendly Childbirth Initiative


Hi all
I have talked with Andrea over the years about the idea of Maternity
Coalition taking up the Mother-Friendly Childbirth material. I
discovered it independently in 1997 or so and we ran an MC workshop
using it as a basis. In 1998 we also organised a lunchtime session at
the Birth amongst Friends conference in Canberra at which anthropologist
Robbie Davis-Floyd talked about the processes of dialogue which finally
produced the CIMS  (Coalition for improving maternity services)consensus
statement that MFCI now is. Robbie had been closely involved in it all
along and I have talked with her since then about its limited but
important role in the US as a model for hospitals to aspire to.

At that time, '98, though there seemed little interest from midwives,
possibly for reasons to do with time and place.  Andrea, I think
rightly, pointed out to me that the dialogue about desirable goals
needed to happen at the Australian level.  I think NMAP and midwifery
developments have now facilitated that, and I for one (not speaking for
MC at all) would like to see us develop a similar 'steps' type program.

What I think MFCI offers is a set of goals clearly spelt out that can be
useful in a variety of settings, including private. It is women-focused
rather than midwife/professional focused which is both philosophically
important but also strategically useful with obs/managers. That it's
used elsewhere can also be valuable, but yes, it needs local
development.

Who else thinks it useful as a basis and is interested in getting such a
process going?
Cheers
Kerreen

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Denise Hynd
Sent: Tuesday, 22 March 2005 8:38 PM
To: [email protected]
Subject: Re: [ozmidwifery] Fw:Mother Friendly Childbirth Initiative

Dear Andrea

It is on the national agenda for the NMAP document to be updated for
example
to cover hospital based 1-2-1 midwifery and the ACMI Giudelines for
Referral

Denise Hynd

"Let us support one another, not just in philosophy but in action, for
the
sake of freedom for all women to choose exactly how and by whom, if by
anyone, our bodies will be handled."

- Linda Hes

----- Original Message ----- From: "Andrea Robertson" <[EMAIL PROTECTED]> To: <[email protected]> Sent: Tuesday, March 22, 2005 5:23 PM Subject: Re: [ozmidwifery] Fw:Mother Friendly Childbirth Initiative

Hi Helen,
We circulated this document at the Future Birth event in 1996 when

Marsden

Wagner was on the speaking team. It has been adapted in several

countries

to reflect local conditions, the most recent one that I saw was for
Thailand where the Childbirth and Breastfeeding Foundation of Thailand

prepared a variation for use in Cambodia, where they were presenting
training workshops for maternity professionals (about 18 months ago

now).

The original version is specifically designed for the US scene (see

the

point about circumcision, as an example) and so would need to be

adapted

for use in OZ. Personally, I think that the NMAP takes its place

here,

and because this document is aimed at strengthening midwifery

practise, it

follows that the resultant care would be more mother friendly.
Cheers
Andrea
At 05:36 PM 20/03/2005, you wrote:
Found this online whilst surfing and wondered if Australia is looking

to

implement this kind of idea too (or an adaptation of same). I have

only

heard of the WHO/UNICEF Baby friendly Hospital Initiative which is

very

much in use in Australia. Can anyone fill me in? It sounds like a

great

idea to me and should give ammunition to those midwives working in
hospitals striving to make improvements in their care/minimize
interventions.  Maybe maternity coalition may be able to formulate
something similar or maybe they have already! - if so, excuse my
ignorance...
Helen Cahill

<http://www.motherfriendly.org/MFCI/steps/>http://www.motherfriendly.o

rg/MFCI/steps/

The Mother-Friendly Childbirth Initiative
Ten Steps of the Mother-Friendly Childbirth Initiative for

Mother-Friendly

Hospitals, Birth Centers, and Home Birth Services

To receive CIMS designation as "mother-friendly," a hospital,
<http://www.motherfriendly.org/MFCI/glossary/#BCenter>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:
   * 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
<http://www.motherfriendly.org/MFCI/glossary/#doula>doula or
labor-support professional:
       * Access to professional midwifery care.
(<http://www.motherfriendly.org/MFCI/references/1/>References)
   * Provides accurate descriptive and statistical information to the

public about its practices and procedures for birth care, including
measures of interventions and

outcomes.(<http://www.motherfriendly.org/MFCI/references/2/>References)

   * 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.(<http://www.motherfriendly.org/MFCI/references/3/>References)

* 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.(<http://www.motherfriendly.org/MFCI/references/4/>References)

   * 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.(<http://www.motherfriendly.org/MFCI/references/5/>References)

   * 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
<http://www.motherfriendly.org/MFCI/glossary/#Rupture>rupture of
membranes;
       * electronic fetal monitoring;
   Other interventions are limited as follows:
       * Has an
<http://www.motherfriendly.org/MFCI/glossary/#Induction>induction

rate of

10% or less;
       * Has an
<http://www.motherfriendly.org/MFCI/glossary/#Episiotomy>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.(<http://www.motherfriendly.org/MFCI/references/6/>References)
   * 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.
(<http://www.motherfriendly.org/MFCI/references/7/>References)
   * 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.(<http://www.motherfriendly.org/MFCI/references/8/>References
)

   * Discourages non-religious circumcision of the

newborn.(<http://www.motherfriendly.org/MFCI/references/9/>References)

* Strives to achieve the WHO-UNICEF "Ten Steps of the

Baby-Friendly

Hospital Initiative" to promote successful breastfeeding:
       * Have a written breastfeeding policy that is routinely
communicated to all health care staff;
       * Train all health care staff in skills necessary to implement

this policy;
       * Inform all pregnant women about the benefits and management

of

breastfeeding;
       * Help mothers initiate breastfeeding within a half-hour of

birth;

* Show mothers how to breast feed and how to maintain

lactation

even if they should be separated from their infants;
       * Give newborn infants no food or drink other than breast milk

unless medically indicated;
       * Practice rooming in: allow mothers and infants to remain
together 24 hours a day;
       * Encourage breastfeeding on demand;
       * Give no artificial teat or pacifiers (also called dummies or

soothers) to breastfeeding infants;
       * Foster the establishment of breastfeeding support groups and

refer mothers to them on discharge from hospitals or

clinics.(References)

-----
Andrea Robertson
Birth International * ACE Graphics * Associates in Childbirth

Education


e-mail: [EMAIL PROTECTED]
web: www.birthinternational.com


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