Mother and Newborn Friendly Birthing Facility

1. 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

2. 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.

3. 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

4. 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

5. 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

6. 10 Criteria for WNFBF • Offers to all birthing women the opportunity to eat ,drink, walk ,stand, move and adopt her preferred positions in labor • Have clear non discriminatory policies on HIV+women, Family Planning and Youth services • Provide privacy in labor/delivery

7. Criteria…. 4. Choice of person for labor partner • Culturally competent care • No physical, verbal, emotional or financial abuse during labor and delivery • 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

8. Criteria….. 8. No routine practices which are not evidence-based. Adequate competent staff, policies for neonatal and maternal resuscitation, policy for transport and referral • Encourage, counsel, and educate staff to provide non pharma and pharma pain relief • Promote skin to skin mother baby contact, encourage to hold and breastfeed babies a soon as possible and provide combine care

9. 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.

10. Indicators matching Criteria • 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.

11. Indicators…… • Written policy and posters on socio/cultural diversity • Written policy against abuse. Complaints policy established. Display Charter of Human Rights • Costs for delivery in line with national guidelines. No secondary payments for care. Costs /policy displayed on walls. • Interventions are evidence based within acceptable national/international ranges

12. Indicators……. • Training of staff on pain relief, choice and monitoring of mother. Offer both pharma and non pharma pain relief. Chart review and patient survey. • Facilitate Skin to skin contact at birth, promote breastfeeding as soon as possible and facility provides combined care of mother/newborn.

13. 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

14. 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

15. 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.

16. 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 alalonde1801@gmail.com FIGO SMNH committee Coordinator of MFBF working group

17. SUMMARY OF INITIATIVE