Mother and Newborn Friendly Birthing FacilityDeveloped 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 CooperAn 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 partner5. Culturally competent care 6. No physical, verbal, emotional or

financial abuse during labor and delivery7. 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 referral9. 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. Written policy on food, movement, labor positions. Info to women, posters, etc.

2. Guideline implementation on HIV/AIDs, FP, Youth services.

3. Privacy walls, curtains..mother /baby care combined

4. 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 1-

2 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 MDalalonde1801@gmail.comFIGO SMNH committeeCoordinator of MFBF working group

SUMMARY OF INITIATIVECRITERIA 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