Finding Mother-Friendly Care – Some Questions to Ask

This article has been excerpted from the publication Having a Baby? 10 Questions to Ask by the Coalition for Improving Maternity Services (CIMS).

 

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 a list of 10 things to look for and ask about, all of which are supported by medical research and are also the best ways to be mother-friendly. Following are three of those questions.

  

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 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 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 that 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 (VBAC).

 

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.

 

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 should 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 cross the placenta and reach the baby and can affect the baby.

Read the remaining 7 questions in the full publication by CIMS.

Have you given birth in a mother-friendly hospital or birth center? What was it like? What was the best part about your care?

Avatar of Cara TerreriAbout Cara Terreri
Cara began working with Lamaze in 2004, two years before becoming a mother. Three kids later, she's a full-fledged healthy birth advocate and the Site Administrator for Giving Birth with Confidence. Most recently Cara began study to become a Lamaze Certified Childbirth Educator and DONA certified doula (learn more about her services at www.SimpleSupportBirth.com). She continues to stand in awe of the power and beauty in pregnancy and birth, and enjoys helping women discover their own power and joy in the journey to motherhood.

Comments

  1. Alice Turner says:

    This list is great. Some mothers might get discouraged if they can’t find a birth setting that meets this criteria. In many areas the c-section rates are well above 10% for all hospitals. In that case, I suggest looking for a provider with a low c-section rate.

  2. Avatar of Cara Terreri Cara Terreri says:

    Alice– thanks for your comment! Yes, the lower the c-section rate, the better. We’d love to strive for 10% or less, but unfortunately that’s just not the case in many hospitals. It’s also a good idea to find out your doctor’s attitude toward c-section as well as his/her rate.

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