Saturday, September 27, 2008

Mother-Friendly Childbirth

What is mother-friendly childbirth?

Coalition for Improving Maternity Services (CIMS) offers several excellent articles on mother-friendly care:

The Mother-Friendly Childbirth Initiative outlines the principles of mother-friendly care. I highly recommend reading the two-page pdf, but these are the principles it highlights:
Normalcy of the Birth Process;
Empowerment;
Autonomy;
Do No Harm;
Responsibility.
Highlights of the Evidence is another two-page pdf that presents the evidence in very straight-forward, easy-to-read language.

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There are so many aspects of mother-friendly care that it's hard to pick one to focus on... To me, mother friendly care is…
• care that considers mother & baby together; what’s good for mother is good for baby.

• care that honors birth as the birth of a mother & family; as an opportunity to empower mothers as they begin their parenting journey.

• care that values mothers, encouraging and supporting them as partners…
But, I think one of the most significant things about mother-friendly care is that it is PERSONALIZED care.

What is “friendly” to one mother may be confusing, overwhelming, or aggravating to another.

For example, in my childbirth classes, we practice contractions holding ice. For the first practice scenario, everyone complains and moans and giggles about how uncomfortable they are. For the second practice, everyone focuses inward and listens to their breathing. The focused breathing practice goes by much faster, and is much less uncomfortable for most people; however, for others, all the distraction of people talking moves time faster. These practice contractions help them realize something about themselves: they might benefit from a big crowd of friends and family supporting & encouraging them during labor; for others, they think about having a quiet, cave where nothing is distracting them from their coping internally.

The point is, what is friendly to one person – no talking, or lots of talking – might not work at all for someone else. Or – it might work better one way for part of labor, and another way later.

Our friends know us. They listen to us. They treat us as individuals.

They know our history & our beliefs…
They know how we are trying to live and they support us…

Mother-friendly care comes from providers who take the time to listen to mothers, to learn about each mother’s history, what she believes about birth…

Does this mother love the water?
Is she anxious about needles?

Mother-friendly care comes from providers who take the time to consider how to best support each particular mother and baby on their birth journey…

Does she need a lot of step-by-step, close support, or would that distract her, pulling her out of her mammal instinctive brain?

…and who then follow-through, basing care decision on that particular mother & baby.

Finally, mother-friendly care is about trust. Friends can trust each other. Mothers should be able to trust that their caregivers will provide personalized care that is based on the best evidence, not on legalities and convenience; that the hospitals and birth centers where they give birth are crafting policies to support and encourage mother-friendly caregiving. With homebirths, families get to make up their own rules, with the guidance of their midwife!

Do I think that’s where we’re at, now, in Central Maine? Where most women give birth in places that support mother-friendly caregivers; that the nurses, doctors, and midwives are mother-friendly?

Sometimes, yes, but (so sadly) I do not think it is the norm here, or in the USA as a whole. Like many people, I struggle with this - how to be an active agent for change? how to encourage others to request (or to insist on!) this type of care? how to show them that they, and their babies, deserve it?

I went to see Birth last night in Gardiner - it was amazing, awesome, sad, beautiful, empowering. I wish the theater had been packed - it wasn't. I wish people had brought their teenage daughters (and sons) to continue an ongoing discussion with them about birth. I wish couples thinking about trying to conceive had come, to open/continue their discussions about the birth of their family. Not that the conversation afterwards wasn't fun and interesting; it was to me - it just would have been even more wonderful if it had reacher a broader segment of the population.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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