Ten Questions to Ask
when Searching for Mother-Friendly Birthing Care
Having a Baby? 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 ten 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.
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.
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.