Step 8: encourages all mothers, families to touch, hold, breastfeed, care for their babies: the coalition for improving maternity services:

Step 8 of the Ten Steps to Mother-Friendly Care 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. The rationales for compliance with the step and systematic review are presented.     

Step 3: provides culturally competent care: the coalition for improving maternity services:

Step 3 of the Ten Steps of Mother-Friendly Care insures that women receive care that is sensitive and responsive to the specific beliefs, values, and customs of the mother's ethnicity and religion. The rationale for this step and the evidence in support of its value are presented.     

Appendix: birth can safely take place at home and in birthing centers: the coalition for improving maternity services:

Although most women in the United States give birth in hospitals, a substantial body of research suggests that planned home birth or birth in freestanding birth centers have equally good or better outcomes for low-risk women. Out-of-hospital birth often facilitates mother-friendly care. Rationales and systematic reviews of both home birth and freestanding birth center birth are presented.     

Commentary: the coalition for improving maternity services:

A consumer advocate, two childbirth educators, and a certified nurse-midwife each provide commentary on the effectiveness of and potential uses for the Evidence Basis for the Ten Steps of Mother-Friendly Care.     

Introduction: the coalition for improving maternity services:

The history of the Coalition for Improving Maternity Services as part of a global effort to promote normal birth is described. The principles underlying the Mother-Friendly Childbirth Initiative are presented, the Ten Steps of Mother-Friendly Care are identified, and the evidence basis for the Ten Steps is introduced.     

Methods: the coalition for improving maternity services:

In this article, the details of the methods used to determine the evidence basis of the Ten Steps of Mother-Friendly Care are presented and discussed.     

Step 4: provides the birthing woman with freedom of movement to walk, move, assume positions of her choice: the coalition for improving maternity services:

Step 4 of the Ten Steps of Mother-Friendly Care insures that women have the freedom to walk, move, and assume positions of their choice during labor and birth. The rationales and the evidence in support of this step are presented.     

Step 9: discourages nonreligious circumcision of the newborn: the coalition for improving maternity services:

Step 9 of the Ten Steps of Mother-Friendly Care discourages nonreligious circumcision of the newborn. The rationale for compliance and systematic review are presented.     

The coalition for improving maternity services: evidence basis for the ten steps of mother-friendly care

One factor explaining why women choose unnecessary high-tech births is their lack of knowledge of the research. Presenting research in Lamaze class can be difficult; however, teaching tools described in this article may help facilitate evidence-based discussions. The recently published Journal of Perinatal Education supplement issue written by the Coalition for Improving Maternity Services Expert Work Group gives Lamaze educators a rich resource to pass along to expectant parents.     

Step 5: has clearly defined policies, procedures for collaboration, consultation, links to community resources: the coalition for improving maternity services:

Step 5 of the Ten Steps of Mother-Friendly Care ensures that the hospital, birth center, or home birth service has clearly defined policies and procedures for collaborating and consulting with other maternity services and for linking the mother and baby to appropriate community services during both the prenatal and the postpartum periods. The rationales and evidence in support of this step are presented.     

Step 6: does not routinely employ practices, procedures unsupported by scientific evidence: the coalition for improving maternity services:

Step 6 of the Ten Steps of Mother-Friendly Care addresses two issues: 1) the routine use of interventions (shaving, enemas, intravenous drips, withholding food and fluids, early rupture of membranes, and continuous electronic fetal monitoring; and 2) the optimal rates of induction, episiotomy, cesareans, and vaginal births after cesarean. Rationales for compliance and systematic reviews are presented.     

Step 7: educates staff in nondrug methods of pain relief and does not promote use of analgesic, anesthetic drugs: the coalition for improving maternity services:

Step 7 of the Ten Steps of Mother-Friendly Care insures that staff are knowledgeable about nondrug methods of pain relief and that analgesic or anesthetic drugs are not promoted unless required to correct a complication. The rationales for compliance and systematic reviews are presented on massage, hypnosis, hydrotherapy, and the use of opioids, regional analgesia, and anesthesia.     

The evidence base for the cues program for mothers of very low birth weight infants: an innovative approach to reduce anxiety and support sensitive interaction

Very low birth weight (VLBW) infants, born weighing less than 1,500 g, are at risk for several developmental problems. Consequently, there has been interest in developing intervention programs to prevent such problems. This article describes the empirical evidence that guided the development of an innovative, multicomponent intervention program for mothers of VLBW infants, as well as the program content and features. Based on the evidence, the program was designed to include six sessions and commence shortly after birth to reduce maternal psychological distress during the infant's hospitalization in the neonatal intensive care unit and to promote sensitive mother-infant interaction. The program incorporates various learning activities, including written materials, observational exercises, discussion, and video feedback.