Capital Area BirthNetwork
A Chapter of BirthNetwork National
It’s your birth. Know your Options
Birth and Beyond: An Resource Guide for Expectant Parents
Please Note:
The Capital Area BirthNetwork is a chapter of Birth Network National. BirthNetwork National encourages you to seek providers who support your personal philosophies. BirthNetwork National does not endorse or recommend providers, but lists those providers who endorse the Mother-Friendly Childbirth Initiative (MFCI) and are paid BirthNetwork National members. BirthNetwork National does not guarantee the provider information contained in this guide and BirthNetwork National does not check the validity or accuracy of credentials including, but not limited to, certifications, licenses or training of any listed provider. There are variations in the philosophies and practices of providers listed. It is the responsibility of each consumer to verify the credentials of providers and BirthNetwork National encourages consumers to interview providers in order to find the care that is right for each individual and family.
Each consumer is responsible for thoroughly interviewing and checking references in selecting a service provider to meet their individual needs. BirthNetwork urges all parents to take responsibility for their birth experience by interviewing several providers, asking detailed questions, and obtaining references.
WELCOME
BirthNetwork National is a national non-profit organization with local roots in Southeastern Michigan. The mission of BirthNetwork National is to promote the awareness and availability of evidence-based maternity care. BirthNetwork National is leading a grassroots movement based on the belief that birth can profoundly affect our physical, mental and spiritual well-being. BirthNetwork National advocates mother-friendly care as defined by the Mother-Friendly Childbirth Initiative (MFCI) through information, confidence, and support. By making informed choices and having confidence in the process, families can experience safe and satisfying childbirth.
This guide is a resource for anyone seeking maternity care providers that have endorsed the Coalition for Improving Maternity Services’ (CIMS) Mother-Friendly Childbirth Initiative (MFCI). By doing so, each provider has stated her/his commitment to provide specialized care for mothers and babies. Mother-friendly care has been proven to be more affordable, healthier and safer than conventional care. You will find a copy of the MFCI in this guide.
The CIMS hand-out “Having a Baby? Ten Questions to Ask” is also included in this guide; this document is based on the MFCI and is a guide for you to use when interviewing providers. If you meet a provider who has never heard of BirthNetwork National or the MFCI, please give her/him a copy of this guide. You can make a positive change in the way women and babies are cared for by insisting on this kind of care.
BirthNetwork National encourages you to learn more about your options in pregnancy and birth. Obtain information and support at our free local chapter meetings. Visit BirthNetwork National’s website at www.birthnetwork.org for more information and resources.
BirthNetwork National encourages you to let your voice be heard. If you have a compliment or complaint about any provider, please let her/him know. Write a letter, make a phone call…caregivers need to know how they rate. If you have goodwill or a grievance, it’s important that you share it. For detailed information on how to file a compliment or complaint, visit BirthNetwork National’s website (www.birthnetwork.org/pdfs/provider_feedback.pdf ).
Above all, it is our desire to promote awareness of the benefits and availability of mother-friendly care. It is our hope that one day mother-friendly care will be the gold standard in all of our communities. Join us as we strive to inform and support those who want to know their options for a healthy pregnancy and birth. By making informed choices and having confidence in the process, women can experience safe and satisfying childbirth.
It’s your birth. Know your options
Childbirth Educator
Jocelyn Bagley
510 Meadowlawn Ave, East Lansing, MI 48823
P (517) 899-6842
Natural childbirth education and nutrition.
Elizabeth and David Brown, AAHCC
Bradley Method® of Husband-Coached Childbirth
1099 East Grand River Road Ste B, Williamston, MI 48895
P (517) 648-7292
F (800) 686-8256
E embrown@knowledgeservices.net
www.bradleybirth.com?B559
We will help you experience the joy of a healthy pregnancy and natural childbirth and teach you non-medicated pain management techniques.
Julie Brown, CD (DONA), Lamaze Trained Childbirth Educator
Mother Birth
2133 Isaac Lane, East Lansing, MI 48823
P (517) 643-2050
Interactive and dynamic private and group instruction supporting the Lamaze philosophy. Classes will empower you to make informed choices for a positive birth experience.
Kip Kozlowski, CNM
Greenhouse Birth Center
1831 Newman Road, Okemos, MI 48864
P (517) 349-2620
F (517) 349-4961
E info@greenhousbirthcenter.com
Lucinda Molzan
Impending Birth
13312 South State Road, Perry, MI 48872
P (517) 402-5694
F (866) 871-6371
Exciting hands on childbirth education inspired by the Lamaze philosophy. Gain the confidence to be an active and informed participant in your child’s birth.
Heather Paris
Mothers Circle
906 Cleo Street, Lansing, MI 48815
P (517) 702-0874
F (517) 349-4962
Mother’s Circle offers a six-week class series that focuses on natural birth. Additional topics are covered including postpartum care, newborn care, and breastfeeding.
Chiropractor
Kristin Batdorf. D.C.
Backbone Chiropractic & Massage Therapy
1770 E Grand River, East Lansing, MI 48823
P (517) 316-1277
The aim of Backbone Chiropractic is to illuminate the path to better health through individualized chiropractic care.
Doula, Birth
Jocelyn Bagley
510 Meadowlawn Ave, East Lansing, MI 48823
P (517) 899-6842
Birth Doula and labor support. Mom Friendly.
Lucinda Molzan
Impending Birth
13312 South State Road, Perry, MI 48872
(517) 402-5694
Prenatal information, prenatal visits, labor support in the setting of your choice, postpartum visits, breastfeeding assistance after the birth.
Mitzi Montague-Bauer
3426 Lucie Street, Lansing, MI 48911
P (517) 243-0165
F (517) 349-4961
27 years of experience providing labor, birth, and postpartum Doula services including fearless childbirth, writing a birth plan, birth photography, and breastfeeding support.
Doula, Postpartum
Julie Brown, CD (DONA)
Mother Birth
2133 Isaac Lane, East Lansing, MI 48823
P (517) 643-2050
Providing postpartum support for new families in their homes. Mom and newborn care, breastfeeding support, light housekeeping, and meal preparation.
Lactation Consultant
Tina Brenner, RN, IBCLC
6137 Green Road, Haslett, MI 48840
P (517) 339-3038
Alt P (517) 282-4399
I am an RN and a Lactation Consultant working in private practice making home visits to breastfeeding families postpartum. I also teach prenatal breastfeeding classes in groups or privately at home.
Massage Therapist
MaryAnn Letevne
Backbone Chiropractic & Massage Therapy
1770 E Grand River, East Lansing, MI 48823
P (517) 230-8193
F (517) 853-1903
MaryAnn caters to women of the childbearing year with deep and/or soothing massage while cradled in a prego comfort pillow in a relaxing environment.
Midwifery
Kip Kozlowski, CNM
Greenhouse Birth Center
1831 Newman Road, Okemos, MI 48864
P (517) 349-2620
F (517) 349-4961
E info@greenhousbirthcenter.com
Kate Mazzara
Mazzara Midwifery
1020 South Hills Drive, Howell, MI 48843
P (810) 333-1325
Full scope midwifery services. VBAC waterbirth. Free consultation. All care provided in your home.
Yoga
Joanne Rowe
Self Realization Meditation Healing Centre
7187 Drumheller Road, Bath, MI 48808
P (517) 641-6201
F (517) 641-8336
Yoga is fun--it relaxes and nurtures your whole being. With Prenatal Transformation Hatha Yoga you can joyfully maintain and strengthen your posture, and tone, prepare, and balance on all levels. For all ages and abilities with individual care from an experienced teacher. Weekly or private classes available, postnatal too.
BirthNetwork National: Birth Resource Guide
BNN’s Suggested Reading List
(May be ordered online at www.birthnetwork.org/books.htm)
Pregnancy-Related Books
Adventures in Natural Childbirth: Tales from Women on the Joys, Fears, Pleasures, and Pains of Giving Birth Naturally--Janet Schwegel and Pam England, Marlowe & Company (March 10, 2005).
A Good Birth, a Safe Birth: Choosing and Having the Childbirth Experience You Want-- Diana Korte and Roberta Scaer, Harvard Common Press; 3 edition (November 25, 1992).
Active Birth: The New Approach to Giving Birth Naturally, Revised Edition--Janet Balaskas, Harvard Common Press; 1 edition (March 25, 1992).
The Birth Partner—Penny Simkin, Harvard Common Press; 2 edition (June 2001)
The Birth Book: Everything You Need to Know to Have a Safe and Satisfying Birth—William Sears & Martha Sears, Little, Brown and Company; 1 edition (February 1, 1994)
Birthing From Within: An Extra-Ordinary Guide to Childbirth Preparation—Pam England, Partera Press; 1 edition (July 1, 1998)
The Complete Book of Pregnancy and Childbirth—Sheila Kitzinger, Knopf; 4 Sub edition (December 30, 2003)
Creating Your Birth Plan: The Definitive Guide to a Safe and Empowering Birth—Marsden Wagner, Stephanie Gunning, Perigee Trade; 1 edition (June 6, 2006)
The Doula Book: How a Trained Labor Companion Can Help You Have a Shorter, Easier, and Healthier Birth-- Marshall Klaus, John Kennell, and Phyllis Klaus, Perseus Publishing; 1 edition (November 5, 2002)
Easing Labor Pain--Adrienne Lieberman, Harvard Common Press; 1 edition (September 25, 1992)
Gentle Birth Choices—Barbara Harper, Healing Arts Press (August 20, 2005)
Heart & Hands—Elizabeth Davis, Celestial Arts; 4 edition (November 2004)
Hypnobirthing: The Mongan Method--A Natural Guide Approach to a Safe, Easier, More Comfortable Birthing--Marie Mongan, HCI; 3 edition (May 24, 2005)
Ina May’s Guide to Childbirth—Ina May Gaskin, Bantam; 1 edition (March 4, 2003)
The Labor Progress Handbook: Early Interventions to Prevent and Treat Dystocia—Penny Simkin, Blackwell Publishing; 2 edition (2005)
Mothering Magazine's Having a Baby, Naturally: The Mothering Magazine Guide to Pregnancy and Childbirth—Peggy O’Mara, Wendy Ponte, Jackie Facciolo, Atria; 1 edition (August 5, 2003)
Natural Childbirth the Bradley Way: Revised Edition—Susan McCutcheon-Rosegg, Plume; Rev Sub edition (July 1, 1996)
The Nurturing Touch at Birth: A Labor Support Handbook—Paulina Perez, International Child Birth Education Association; Updated, revised Second edition (March 10, 2006)
The Official Lamaze Guide: Giving Birth with Confidence—Judith Lothian and Charlotte DeVries, Simon & Schuster, Inc.; 1 edition (October 4, 2005)
Pregnancy, Childbirth and the Newborn: The Complete Guide—Penny Simkin, Janet Whalley and Ann Keppler, Simon & Schuster; 3 edition (2001)
The Pregnancy Book: Month-by-Month, Everything You Need to Know From America's Baby Experts—Martha Sears, William Sears, Linda Hughey, Little, Brown and Company (June 1, 1997)
The Thinking Woman’s Guide to a Better Birth—Henci Goer, Perigee Trade; 1 edition (October 1, 1999)
The VBAC Companion: The Expectant Mother’s Guide to Vaginal Birth After Cesarean—Diana Korte, Harvard Common Press; 1 edition (October 25, 1997)
Breastfeeding Books
Bestfeeding: How to Breastfeed Your Baby—Mary Renfrew, Celestial Arts Publishing; 3 edition (2004)
Breastfeeding, A Parent’s Guide—Amy Spangler, Amy Spangler; 8 edition (February 16, 2006)
Breastfeeding for One, Two, or Three, A Nursing Mother’s Survival Guide for One Child, Twins, Triplets, or More—Maria S. McCarthy, Maria Skantzaris\McCarthy (November 2004)
The Breastfeeding Book: Everything You Need to Know About Nursing Your Child from Birth through Weaning—Martha Sears, Little, Brown and Company; 1 edition (March 2, 2000)
The Nursing Mother’s Companion—Kathleen Huggins, Harvard Common Press; 5 edition (March 1, 2005)
So That’s What They’re For! The Definitive Breastfeeding Guide—Janet Tamaro, Adams Media Corporation; 3 edition (June 2005)
The Ultimate Breastfeeding Book of Answers Revised and Updated: The Most Comprehensive Problem-Solving Guide to Breastfeeding from the Foremost Expert in North America —Jack Newman, Teresa Pitman, Three Rivers Press; 1 edition (November 28, 2006)
The Womanly Art of Breastfeeding—Gwen Gotsch, Plume; 6th Rev edition (September 1, 1997)
Organizations
American College of Nurse-Midwives (ACNM) 8403 Colesville Rd, Suite 1550
Silver Spring, MD 20910
(240) 485-1800, www.acnm.org/
American College of Obstetricians and Gynecologists (ACOG)
409 12th St., S.W., PO Box 96920
Washington, D.C. 20090-6920
(202) 638-5577, www.acog.org
Association of Labor Assistants and Childbirth Educators (ALACE)
P.O. Box 390436
Cambridge, MA 02139
(888) 222-5223, www.alace.org
Birth Works, Inc.
P.O. Box 2045
Medford, NJ 08055
(888) 862-4784, www.birthworks.org
The Bradley Method of Natural Childbirth
Box 5224
Sherman Oaks, CA 91413-5224
(800) 4-A-BIRTH, www.bradleybirth.com
Childbirth Connection
(formerly “Maternity Center Association”)
281 Park Avenue South, 5th Floor
New York, NY 10010
Phone: (212) 777-5000, www.childbirthconnection.org
Citizen’s for Midwifery
P.O.Box 82227
Athens, GA 30608-2227
Phone: 1-888-CfM-4880, www.cfmidwifery.og
Coalition for Improving Maternity Services (CIMS)
P.O. Box 2346
Ponte Vedra Beach, FL 32004
(888)282-CIMS, www.motherfriendly.org
DONA International
PO Box 626
Jasper, IN 47547
(888)788-DONA, www.dona.org
International Cesarean Awareness Network (ICAN)
1304 Kingsdale Avenue
Redondo Beach, CA 90278
(800) 686-ICAN, www.ican-online.org
International Childbirth Education Association (ICEA)
PO Box 20048
Minneapolis, MN 55420
(612)854-8660, www.icea.org
La Leche League
1400 North Meacham Road
Schaumberg, IL 60173-4048
(800) LALECHE, www.lalecheleague.org
Lamaze International
2025 M Street
Suite 800
Washington DC 20036-3309
(800) 368-4404, www.lamaze.org
Midwives Alliance of North America (MANA)
4805 Lawrenceville Hwy, Suite 116-279
Lilburn, GA 30047
888-923-MANA (6262), www.mana.org
National Association of Childbearing Centers (NACC)
3123 Gottschall Road
Perkiomenville, PA 18074-9546
Phone: (215) 234-8068, www.BirthCenters.org
Definitions
Certified Nurse Midwife (CNM) - A Certified Nurse Midwife (CNM) is an individual educated in two disciplines--nursing and midwifery--who possesses evidence of certification according to the requirements of the American College of Nurse-Midwives.
Certified Professional Midwife (CPM) - A CPM is an independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the midwifery model of care. The CPM is the only international credential that requires knowledge about and experience in out-of-hospital settings.
Childbirth Educator (CBE) - A person or team of people who educate expectant mothers and/or their partners on what to expect during childbirth. A CBE may be an employee of a hospital or birth center or may offer classes independently. The curriculum taught depends on the philosophy of childbirth.
Chiropractor – One who provides chiropractic care, a system of therapy in which disease or discomfort is considered the result of abnormal function of the nervous system. The method of treatment usually involves manipulation of the spinal column and other body structures.
Direct-Entry Midwife (DEM) - A DEM is an independent practitioner educated in the discipline of midwifery through self-study, apprenticeship, a midwifery school, or a college- or university-based program distinct from the discipline of nursing. A direct-entry midwife provides care to healthy women (and newborns) throughout the childbearing cycle, primarily in out-of-hospital settings.
Doula, Birth - Doulas are not primary health care providers, but rather work as part of a team that includes either a midwife or a doctor as the primary care provider. They provide emotional, educational, and physical support. A doula may be a personal friend or a hired professional and may or may not be certified. Doulas may also be called: labor support person, childbirth assistant, labor companion, or Certified Doula (CD). Some doulas provide both labor and postpartum support.
Doula, Postpartum – A postpartum doula is a person who is specially trained to help after the birth of a baby. She might help a new mother breastfeed or cook, clean, and care for older children. A doula may be a personal friend or a hired professional and may or may not be certified. Some doulas provide both labor and post-partum support.
Family Practitioner - A general practitioner who provides one-stop care for all ages, the family practitioner has several years of specialty training in primary care, including obstetrics.
Gynecologist - A physician who specializes in women's reproductive health.
Lactation Consultant - Someone who educates and assists breastfeeding mothers. May also be a registered nurse (RN) or registered lactation consultant (RLC).
Massage Therapist – One who provides assessment, treatment and prevention of soft tissue and joint disorders, dysfunction or injury using treatment methods which may include manual techniques, hydrotherapy, light therapy, electrical modalities, therapeutic exercise and patient education to rehabilitate, relieve pain and promote overall health. May or may not be certified.
Monitrice – This is a practitioner who has the skills to evaluate early labor progress and monitor vital signs. A monitrice may be a registered nurse (RN).
Obstetrician/Gynecologist (Ob-Gyn) - A physician specializing in women's reproductive health, an Ob-Gyn typically has three years of post-medical school training.
Pediatrician - A physician who specializes in treating infants and children up to adolescence.
The Mother-Friendly Childbirth Initiative
The First Consensus Initiative of the Coalition for Improving Maternity Services
© 1996 by The Coalition for Improving Maternity Services (CIMS).
Mission
The Coalition for Improving Maternity Services (CIMS) is a coalition of individuals and national organizations with concern for the care and wellbeing of mothers, babies, and families. Our mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs. This evidence-based mother-, baby-, and family-friendly model focuses on prevention and wellness as the alternatives to high-cost screening, diagnosis, and treatment programs.
Preamble
Whereas:
• In spite of spending far more money per capita on maternity and newborn care than any other country, the United States falls behind most industrialized countries in perinatal* morbidity* and mortality, and maternal mortality is four times greater for African-American women than for Euro-American women;
• Midwives attend the vast majority of births in those industrialized countries with the best perinatal outcomes, yet in the United States, midwives are the principal attendants at only a small percentage of births;
• Current maternity and newborn practices that contribute to high costs and inferior outcomes include the inappropriate application of technology and routine procedures that are not based on scientific evidence;
• Increased dependence on technology has diminished confidence in women’s innate ability to give birth without intervention;
• The integrity of the mother-child relationship, which begins in pregnancy, is compromised by the obstetrical treatment of mother and baby as if they were separate units with conflicting needs;
• Although breastfeeding has been scientifically shown to provide optimum health, nutritional, and developmental benefits to newborns and their mothers, only a fraction of U.S. mothers are fully breastfeeding their babies by the age of six weeks;
• The current maternity care system in the United States does not provide equal access to health care resources for women from disadvantaged population groups, women without insurance, and women whose insurance dictates caregivers or place of birth;
Therefore,
We, the undersigned members of CIMS, hereby resolve to define and promote mother-friendly maternity services in accordance with the following principles:
Principles
We believe the philosophical cornerstones of mother-friendly care to be as follows:
Normalcy of the Birthing Process
• Birth is a normal, natural, and healthy process.
• Women and babies have the inherent wisdom necessary for birth.
• Babies are aware, sensitive human beings at the time of birth, and should be acknowledged and treated as such.
• Breastfeeding provides the optimum nourishment for newborns and infants.
• Birth can safely take place in hospitals, birth centers, and homes.
• The midwifery model of care, which supports and protects the normal birth process, is the most appropriate for the majority of women during pregnancy and birth.
Empowerment
• A woman’s confidence and ability to give birth and to care for her baby are enhanced or diminished by every person who gives her care, and by the environment in which she gives birth.
• A mother and baby are distinct yet interdependent during pregnancy, birth, and infancy. Their interconnected–ness is vital and must be respected.
• Pregnancy, birth, and the postpartum period are milestone events in the continuum of life. These experiences profoundly affect women, babies, fathers, and families, and have important and long-lasting effects on society.
Autonomy
Every woman should have the opportunity to:
• Have a healthy and joyous birth experience for herself and her family, regardless of her age or circumstances;
• Give birth as she wishes in an environment in which she feels nurtured and secure, and her emotional well-being, privacy, and personal preferences are respected;
• Have access to the full range of options for pregnancy, birth, and nurturing her baby, and to accurate information on all available birthing sites, caregivers, and practices;
• Receive accurate and up-to-date information about the benefits and risks of all procedures, drugs, and tests suggested for use during pregnancy, birth, and the postpartum period, with the rights to informed consent and informed refusal;
• Receive support for making informed choices about what is best for her and her baby based on her individual values and beliefs.
Do No Harm
• Interventions should not be applied routinely during pregnancy, birth, or the postpartum period. Many standard medical tests, procedures, technologies, and drugs carry risks to both mother and baby, and should be avoided in the absence of specific scientific indications for their use.
• If complications arise during pregnancy, birth, or the postpartum period, medical treatments should be ¬evidence-based.
Responsibility
• Each caregiver is responsible for the quality of care she or he provides.
• Maternity care practice should be based not on the needs of the caregiver or provider, but solely on the needs of the mother and child.
• Each hospital and birth center is responsible for the periodic review and evaluation, according to current scientific evidence, of the effectiveness, risks, and rates of use of its medical procedures for mothers and babies.
• Society, through both its government and the public health establishment, is responsible for ensuring access to maternity services for all women, and for monitoring the quality of those services.
• Individuals are ultimately responsible for making informed choices about the health care they and their babies receive.
These principles give rise to the following steps, which support, protect, and promote mother-friendly maternity services:
* see glossary below
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, birth center, or home birth service must carry out the above 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 or water;
• early rupture of membranes*;
• electronic fetal monitoring;
other interventions are limited as follows:
• Has an induction* rate of 10% or less;†
• 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:
1. Have a written breastfeeding policy that is routinely communicated to all health care staff;
2. Train all health care staff in skills necessary to implement this policy;
3. Inform all pregnant women about the benefits and management of breastfeeding;
4. Help mothers initiate breastfeeding within a half-hour of birth;
5. Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants;
6. Give newborn infants no food or drink other than breast milk unless medically indicated;
7. Practice rooming in: allow mothers and infants to remain together 24 hours a day;
8. Encourage breastfeeding on demand;
9. Give no artificial teat or pacifiers (also called dummies or soothers) to breastfeeding infants;
10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from hospitals or clinics.
† This criterion is presently under review.
* Glossary
Augmentation: Speeding up labor.
Birth Center: Free-standing maternity center.
Doula: A woman who gives continuous physical, emotional, and informational sup¬port during labor and birth—may also provide postpartum care in the home.
Episiotomy: Surgically cutting to widen the vaginal opening for birth.
Induction: Artificially starting labor.
Morbidity: Disease or injury.
Oxytocin: Synthetic form of oxytocin (a naturally occurring hormone) given intravenously to start or speed up labor.
Perinatal: Around the time of birth.
Rupture of Membranes: Breaking the “bag of waters.”
Bibliography
American College of Obstetricians and Gynecologists. Fetal heart rate patterns: monitoring, interpretation, and management. Technical Bulletin No. 207, July 1995.
—. Guidelines for vaginal delivery after a previous cesarean birth. ACOG Committee Opinion 1988; No 64.
Canadian Paediatric Soc, Fetus, and Newborn Committee. Neonatal circumcision revisited. Can Med Assoc J 1996;154(6):769-780.
Enkin M, et al. A Guide to Effective Care in Pregnancy and Childbirth 2nd rev ed. Oxford: Oxford University Press, 1995. (Data from this book come from the Cochrane Database of Perinatal Trials.)
Goer H. Obstetric Myths Versus Research Realities: A Guide to the Medical Literature. Westport, CT: Bergin and Garvey, 1995.
Bureau of Maternal and Child Health. Unity through diversity: a report on the Healthy Mothers Healthy Babies Coalition Communities of Color Leadership Roundtable. Healthy Mothers Healthy Babies, 1993. (A copy may obtained by calling (202) 821-8993 ext. 254. Dr. Marsden Wagner also provided maternal mortality statistics from official state health data.)
International Lactation Consultant Association. Position paper on infant feeding. rev 1994. Chicago: ILCA, 1994.
Klaus M, Kennell JH, and Klaus PH. Mothering the Mother. Menlo Park, CA: Addison-Wesley, 1993.
—. Bonding: Building the Foundations of Secure Attachment and Independence. Menlo Park, CA: Addison-Wesley,1995.
Wagner M. Pursuing the Birth Machine: The Search for Appropriate Birth Technology. Australia: ACE Graphics, 1994. (Dr. Wagner’s book has the “General Recommendations” of The WHO Fortaleza, Brazil, April, 1985 and the “Summary Report” of The WHO Consensus Conference on Appropriate Technology Following Birth Trieste, October, 1986.
Ratified by these members of the Coalition for Improving Maternity Services (CIMS), July, 1996
Organizations (names of organizations’ officers may have changed since ratification):
Academy of Certified Birth Educators (Olathe, KS), Linda M. Herrick, RNC, BSN, CCE, CD; and Sally Riley, BSEd, CCE, CD, & Judie C. Wika, RNC, MSN, CNM, CCE, Co-Directors
American Academy of Husband-Coached Childbirth (The Bradley Method™), (Sherman Oaks, CA), Jay and Marjie Hathaway, Executive Directors
American College of Nurse-Midwives (Washington, DC), Joyce Roberts, CNM, PhD, FACNM, President
American College of Domiciliary Midwives (Palo Alto, CA), Faith Gibson, CPM, Executive Director
Association of Labor Assistants and Childbirth Educators (Cambridge, MA), Jessica L. Porter, President
Association for Pre- & Perinatal Psychology and Health (Geyserville, CA), David B. Chamberlain, PhD, President
Association of Women’s Health, Obstetrics, and Neonatal Nurses (Washington, DC), Joy Grohar, RNC, MS, President
Attachment Parenting International, (Nashville, TN), Lysa Parker, BS, & Barbara Nicholson, MEd, Co-Founders
Birthworks, Inc. (Medford, NJ), Cathy E. W. Daub, RPT, CCE, President
Center for Perinatal Research & Family Support (River Vale, NJ), Debra Pascali-Bonaro, Executive Director
Doulas of North America (Seattle, WA), Barbara A. Hotelling, RN, BSN, CD, FACCE, President
The Farm (Summertown, TN), Ina May Gaskin, President
Global Maternal/Child Health Association (Wilsonville, OR), Barbara Harper, RN, President
Informed Home Birth/Informed Birth & Parenting (Fair Oaks, CA), Rahima Baldwin Dancy, CPM, President
International Association of Infant Massage (Oak View, CA), Ellen Kerr, RN, BSN, MST, CIMI, President
International Childbirth Education Association (Minneapolis, MN), Cheryl Coleman, RN, BSN, ICCE, President
International Lactation Consultant Association (Chicago, IL), Karen Kerkhoff Gromada, MSN, RN, IBCLC, President
La Leche League International (Schaumburg, IL), Carol Kolar, RN, Director of Education & Outreach
Lamaze International (formerly ASPO/Lamaze), (Washington, DC), Deborah Woolley, CNM, PhD, FACCE, President
Midwifery Today (Eugene, OR), Jan Tritten, TMME, Editor
Midwives Alliance of North America (Newton, KS), Ina May Gaskin, President
Midwives of Santa Cruz (Santa Cruz, CA), Roxanne Potter, CNM, Kate Bowland, CNM, Co-Directors
National Association of Childbearing Centers (Perkiomenville, PA), Susan Stapleton, MSN, CNM, President
National Association of Postpartum Care Services (Edmunds, WA), Gerri Levrini, RN, MSN, CNAA, President
North American Registry of Midwives (Nashville, TN), Sharon Wells, MS, LM,CPM, Coordinator
Wellness Associates (Afton, VA), John W. Travis, MD, MPH, & Meryn G. Callander, ME, BSW, Co-Directors
Individuals:
Sondra Abdulla-Zaimah, RN, CNM, CPM, Senegal, W. Africa
Shannon Anton, CPM, San Francisco, CA
Susanne Arms, Bayfield, CO, Immaculate Deception
Gini Baker, RN, MPH, IBCLC, FACCE, Escondido, CA
Maggie Bennett, LM, CPM, Seaside, CA
Brian Berman, Bainbridge Island, WA
Mary Brucker, CNM, DNSc, Dallas, TX
Elena Carrillo, LCCE, FACCE, CD, Mexico City, Mexico
Raymond Castellino, DC, RPP, Santa Barbara, CA
Robbie Davis-Floyd, PhD, Austin, TX, Birth as an American Rite of Passage
Henci Goer, BA, ACCE, Sunnyvale, CA, The Thinking Woman's Guide to a Better Birth
Dorothy Harrison, IBCLC, Edmunds WA
Jack Heinowitz, PhD, San Diego, CA, Pregnant Fathers
Tina Kimmel, MSW, MPH, Berkeley, CA
Marshall Klaus, MD, Berkeley, CA, Bonding—Building the Foundation for Secure Attachment and Independence
Phyllis Klaus, CSW, MFCC, Berkeley, CA, The Amazing Newborn
Judith Lothian, RN, PhD, FACC, Brooklyn, NY
Susan Sobin Pease, MBA, CIMI, CMT, San Francisco, CA
Paulina G. Perez, RN, BSN, FACCE, Johnson, VT Special Women
James W. Prescott, PhD, San Diego, CA , Brain Function and Malnutrition
Mayri Sagady, RN, CNM, MSN, San Diego, CA
Karen N. Salt, CCE, Coconino Community College, Flagstaff, AZ
Irene Sandvold, DrPH, CNM, Rockville, MD
Roberta M. Scaer, MSS, Boulder, CO, A Good Birth, A Safe Birth
Betsy K. Schwartz, MMHS, Coconut Creek, FL
Penny Simkin, PT, Seattle, WA, Pregnancy, Childbirth, and the Newborn:
Linda J. Smith, BSE, FACCE, Bright Future Lactation Resource Centre., Dayton, OH
Suzanne Suarez, JD, RN, Tampa, FL
Sandy Szalay, ARNP, CCE, Seattle, WA
Marsden Wagner, MD, MSPH, Washington, DC, Pursuing the Birth Machine
Diony Young, Geneseo, NY
Permission granted to freely reproduce in whole or in part along with complete attribution.
CIMS National Office
PO Box 2346
Ponte Vedra Beach, FL 32004
888-282-CIMS
Having a Baby?
Ten Questions to Ask
©2000 by the Coalition for Improving Maternity Services
Have you decided how to have your baby?
The choice is yours!
First, you should learn as much as you can about all your choices. There are many different ways of caring for a mother and her baby during labor and birth.
Birthing care that is better and healthier for mothers and babies is called “mother-friendly.” Some birth places or settings are more mother-friendly than others.
A group of experts in birthing care came up with this list of 10 things to look for and ask about. Medical research supports all of these things. These are
also the best ways to be mother-friendly.
When you are deciding where to have your baby, you'll probably be choosing from different places such as:
• birth center,
• hospital, or
• home birth service.
Here’s what you should expect, and ask for, in your birth experience. Be sure to find out how the people you talk with handle these 10 issues about caring for you and your baby. You may want to ask the questions below to help you learn more.
1. Ask, “Who can be with me during labor and birth?”
Mother-friendly birth centers, hospitals, and home birth services will let a birthing mother decide whom she wants to have with her during the birth. This includes fathers, partners, children, other family members, or friends.
They will also let a birthing mother have with her a person who has special training in helping women cope with labor and birth. This person is called a doula or labor support person. She never leaves the birthing mother alone. She encourages her, comforts her, and helps her understand what’s happening to her.
They will have midwives as part of their staff so that a birthing mother can have a midwife with her if she wants to.
2. Ask, “What happens during a normal labor and birth in your setting?”
If they give mother-friendly care, they will tell you how they handle every part of the birthing process. For example, how often do they give the mother a drug to speed up the birth? Or do they let labor and birth usually happen on its own timing?
They will also tell you how often they do certain procedures. For example, they will have a record of the percentage of C-sections (Cesarean births) they do every year. If the number is too high, you’ll want to consider having your baby in another place or with another doctor or midwife.
Here are some numbers we recommend you ask about.
• They should not use oxytocin (a drug) to start labor for more than 1 in 10 women (10%).
• They should not do an episiotomy (ee-pee-zee-AH-tummy) on more than 1 in 5 women (20%). They should be trying to bring that number down. (An episiotomy is a cut in the opening to the vagina to make it larger for birth. It is not necessary most of the time.)
• They should not do C-sections on more than 1 in 10 women (10%) if it’s a community hospital. The rate should be 15% or less in hospitals which care for many high-risk mothers and babies.
A C-section is a major operation in which a doctor cuts through the mother’s stomach into her womb and removes the baby through the opening. Mothers who have had a C-section can often have future babies normally. Look for a birth place in which 6 out of 10 women (60%) or more of the mothers who have had C-sections go on to have their other babies through the birth canal.
3. Ask, “How do you allow for differences in culture and beliefs?”
Mother-friendly birth centers, hospitals, and home birth services are sensitive to the mother’s culture. They know that mothers and families have differing beliefs, values, and customs.
For example, you may have a custom that only women may be with you during labor and birth. Or perhaps your beliefs include a religious ritual to be done after birth. There are many other examples that may be very important to you. If the place and the people are mother-friendly, they will support you in doing what you want to do. Before labor starts tell your doctor or midwife special things you want.
4. Ask, “Can I walk and move around during labor?
What position do you suggest for birth?”
In mother-friendly settings, you can walk around and move about as you choose during labor. You can choose the positions that are most comfortable and work best for you during labor and birth. (There may be a medical reason for you to be in a certain position.) Mother-friendly settings almost never put a woman flat on her back with her legs up in stirrups for the birth.
5. Ask, “How do you make sure everything goes smoothly when my nurse, doctor, midwife, or agency need to work with each other?”
Ask, “Can my doctor or midwife come with me if I have to be moved to another place during labor? Can you help me find people or agencies in my community who can help me before and after the baby is born?”
Mother-friendly places and people will have a specific plan for keeping in touch with the other people who are caring for you. They will talk to others who give you birth care. They will help you find people or agencies in your community to help you. For example, they may put you in touch with someone who can help you with breastfeeding.
6. Ask, “What things do you normally do to a woman
in labor?”
Experts say some methods of care during labor and birth are better and healthier for mothers and babies. Medical research shows us which methods of care are better and healthier. Mother-friendly settings only use methods that have been proven to be best by scientific evidence.
Sometimes birth centers, hospitals, and home birth services use methods that are not proven to be best for the mother or the baby. For example, research has shown it’s usually not helpful to break the bag of waters.
Here is a list of things we recommend you ask about. They do not help and may hurt healthy mothers and babies. They are not proven to be best for the mother or baby and are not mother-friendly.
• They should not keep track of the baby’s heart rate all the time with a machine (called an electronic fetal monitor). Instead it is best to have your nurse or midwife listen to the baby's heart from time to time.
• They should not break your bag of waters early in labor.
• They should not use an IV (a needle put into your vein to give you fluids).
• They should not tell you that you can't eat or drink during labor.
• They should not shave you.
• They should not give you an enema.
A birth center, hospital, or home birth service that does these things for most of the mothers is not mother-friendly. Remember, these should not be used without a special medical reason.
7. Ask, “How do you help mothers stay as comfortable as they can be? Besides drugs, how do you help mothers relieve the pain of labor?”
The people who care for you should know how to help you cope with labor. They should know about ways of dealing with your pain that don’t use drugs. They should suggest such things as changing your position, relaxing in a warm bath, having a massage and using music. These are called comfort measures.
Comfort measures help you handle your labor more easily and help you feel more in control. The people who care for you will not try to persuade you to use a drug for pain unless you need it to take care of a special medical problem. All drugs affect the baby.
8. Ask, “What if my baby is born early or has special problems?”
Mother-friendly places and people will encourage mothers and families to touch, hold, breastfeed, and care for their babies as much as they can. They will encourage this even if your baby is born early or has a medical problem at birth. (However, there may be a special medical reason you shouldn't hold and care for your baby.)
9. Ask, “Do you circumcise baby boys?”
Medical research does not show a need to circumcise baby boys. It is painful and risky. Mother-friendly birth places discourage circumcision unless it is for religious reasons.
10. Ask, “How do you help mothers who want to breastfeed?”
The World Health Organization made this list of ways birth services support breastfeeding.
• They tell all pregnant mothers why and how to breastfeed.
• They help you start breastfeeding within
1 hour after your baby is born.
• They show you how to breastfeed. And they show you how to keep your milk coming in even if you have to be away from your baby for work or other reasons.
• Newborns should have only breast milk. (However, there may be a medical reason they cannot have it right away.)
• They encourage you and the baby to stay together all day and all night. This is called “rooming-in.”
• They encourage you to feed your baby whenever he or she wants to nurse, rather than at certain times.
• They should not give pacifiers (“dummies” or “soothers”) to breastfed babies.
• They encourage you to join a group of mothers who breastfeed. They tell you how to contact a group near you.
• They have a written policy on breastfeeding. All the employees know about and use the ideas in the policy.
• They teach employees the skills they need to carry out these steps.
Would you like to give this information (and more)to your doctor, midwife, or nurse?
This information taken from The Mother-Friendly Childbirth Initiative written for health care providers. You can get a copy of the Initiative for your doctor, midwife, or nurse by mail, e-mail, or on the World Wide Web.
To Get a Copy by Mail
Write to:
CIMS National Office
PO Box 2346
Ponte Vedra Beach, FL 32004
888-282-CIMS
904-285-1613
Fax 904-285-2120
For a copy of both this brochure and The Mother-Friendly Childbirth Initiative by mail, send a stamped self-addressed envelope with $3 (US) to help cover the costs ($4 Canada or Mexico, $5 all others). Bulk prices available.
Permission granted to freely reproduce in whole or in part along with complete attribution.
To Get Copies on the Web
904-285-1613
Fax 904-285-2120
Birth and Beyond: A Resource Guide for Expectant Parents
