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Mother and Newborn Friendly
Birthing Facility
Developed in partnership with :
• FIGO: S.Miller, C Hanson, A. Lalonde
• ICM : J.Brown
• WHO: F.McConville, AG Portella, M Mathai
• WRA: Mande Limbu
• IPA: Z Bhutta, W. Keenan, P Cooper
An initiative of the FIGO SMNH Committee
in collaboration with IPA
Whereas
EVERY MOTHER/NEWBORN has the right to
be treated with DIGNITY and RESPECT
regardless of social status, including but not
limited to : young, single, poor, uneducated,
HIV+, minority.
What has lead us to this Initiative
• Unacceptable gap in MNM depending on
access to quality care.
• Right to positive birth experience and
compassionate care.
• Protection against unnecessary interventions
and practice not respectful of the culture,
bodily integrity, and dignity of MN
• A positive birth experience is related to a
healthy delivery outcome for mother and
newborn
Charter on the Universal Rights of
Childbearing Women(URCBW
• Foundation Document underlying
initiative
• Raise awareness of childbearing
women’s inclusion in UN and
other treaties.
• Connection between human rights
and quality maternity care
Charter of Universal Rights of
Childbearing Women
• Increase capacity of MNH advocates to
participate in Human Rights process
• Align mothers entitlement to High-Quality
MNC with International human rights and
community standards
• Hold MNC system and communities
accountable to these rights
10 Criteria for WNFBF
1. Offers to all birthing women the
opportunity to eat ,drink, walk ,stand,
move and adopt her preferred positions
in labor
2. Have clear non discriminatory policies on
HIV+women, Family Planning and Youth
services
3. Provide privacy in labor/delivery
Criteria….
4. Choice of person for labor partner
5. Culturally competent care
6. No physical, verbal, emotional or
financial abuse during labor and delivery
7. Affordable costs, free maternity care if
possible. Fees should be reasonable and
posted. Inability to pay is not a reason to
deny care, no detention of mother/baby
Criteria…..
8. No routine practices which are not
evidence-based. Adequate competent staff,
policies for neonatal and maternal
resuscitation, policy for transport and referral
9. Encourage, counsel, and educate staff to
provide non pharma and pharma pain relief
10.Promote skin to skin mother baby contact,
encourage to hold and breastfeed babies a
soon as possible and provide combine care
Process
• All partners will work together to train
individuals to conduct site visits, evaluate
sites and recommend changes if necessary
to qualify for certification
• Facility certification will be for 3-5 year
period, one year probation is possible for
birthing unit that fulfills 80% of indicators
and working to achieve others.
Indicators matching Criteria
1.
2.
3.
4.
Written policy on food, movement, labor
positions. Info to women, posters, etc.
Guideline implementation on HIV/AIDs,
FP, Youth services.
Privacy walls, curtains..mother /baby
care combined
Written policy for person of choice,
encourage TBAs to participate in care of
the women referred.
Indicators……
5. Written policy and posters on socio/cultural
diversity
6. Written policy against abuse. Complaints
policy established. Display Charter of
Human Rights
7. Costs for delivery in line with national
guidelines. No secondary payments for
care. Costs /policy displayed on walls.
8. Interventions are evidence based within
acceptable national/international ranges
Indicators…….
9. Training of staff on pain relief, choice and
monitoring of mother. Offer both
pharma and non pharma pain relief.
Chart review and patient survey.
10.Facilitate Skin to skin contact at birth,
promote breastfeeding as soon as
possible and facility provides combined
care of mother/newborn.
Enabling policies
• The facility has a supportive human resource
policy in place for recruitment and retention of
all staff, ensures staff are safe and secure,
enabled to provide quality of care
• Exemption policy that protects dedicated and
experienced labour ward staff (midwives, nurses
and doctors) from being transferred to other
departments
Enabling Measures…
• Women are supported and encouraged to
have as normal a pregnancy and birth as
possible, with evidenced-based
interventions
• Comfortable, clean, safe setting that
promotes the wellbeing of women,
families and facility staff
• A physical environment (including safe
water and clean sanitation ) that supports
normal birth outcomes
Implementation
• ICM/FIGO/IPA will work with governments,
national, local professional associations,
UN agencies such as
UNICEF/WHO/UNFPA/WB and WRA to
implement this initiative.
• All organizations can be equal partners in
this effort .
• Possible pilot project implementation in 12 countries.
Conclusion
• Look forward to ideas, suggestions about
funding, implementation and collaboration
• Special thanks to Dr. Suellen Miller and Claudia
Hansen for their contribution to developing this
initiative
Andre lalonde MD
[email protected]
FIGO SMNH committee
Coordinator of MFBF working group
SUMMARY OF INITIATIVE
CRITERIA
INDICATORS
Adopt preferred positions in labor for
women, provide food and beverage
Written policy and implementation
Non discriminatory policy for HIV+
women, FP and Youth services
Implementation of guidelines for HIV+
women, FP and Youth services
Privacy in labor / delivery
Curtains, walls, etc.
Choice of birthing partner
Accommodation of partners
Culturally competent care
Training, posters, policies
No physical, verbal, emotional and
financial abuse
Written policy, display Charter of
Human Rights
Affordable cost, free maternity care
Costs in line with national guidelines
No routine practice
Evidence-based interventions
Non-pharma and pharma pain relief
Training on pain relief
Skin to skin mother baby care,
breastfeeding
Provide combined care mother/baby,
breastfeeding