The Coalition for Improving Maternity Services (CIMS) is an allied group of individuals and national organizations with a concern for the care and well-being of mothers, babies and families. Its goal 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.

Its preamble states:

• 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;

• Although breastfeeding has been scientifically shown to provide optimum health, nutritional, and developmental benefits to newborn and their mothers, only a fraction of U.S. mothers are fully breastfeeding their babies by the age of 6 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.

PRINCIPLES

The undersigned members of CIMS, have resolved to define and promote mother-friendly maternity services in accordance with the belief that the philosophical cornerstones of mother-friendly care are:

• 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.

• Mother and baby are distinct yet interdependent during pregnancy, birth, and infancy. Their interconnectedness 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

The coalition believes that 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.

- Source: Taken from

“The Coalition for Improving Maternity Services” (CIMS) www.motherfriendly.org.

Andrea Branagan, MA, CNMI, is a childbirth educator and health care advocate. She is an associate with Choice's West, A Center for Women's Health, and the director of education for “Gentle Birth Choices.” To learn more, visit www.gentlebirthchoices.net