Action Ideas & Reflection on Past/Current Action

This project involves, ultimately, a plan for action that will serve to inform and educate all Americans about the importance of prompt change in maternity care. Some of the changes that will need to be made include proper informed consent, transparency of care, and a focus on mother-friendly care versus profit-making or convenience care, among others.

To define what such changes would look like in the real world, I will pause here to explain the three main foci that were just listed. First, informed consent means giving a patient of medical care (in this case, maternity care during labor and birth) full disclosure of information about the possible procedures that are offered or recommended, explaining all risks and benefits of said procedure(s), and giving the patient the uninfluenced option to accept or refuse care. Second, transparency of care refers to the full disclosure of what procedures are being performed by hospitals and medical providers, as well as outcomes of medical care--this includes an easily accessible, public display of intervention (cesarean section, induction of labor, epidural/analgesia, other surgical procedure, etc.) rates for each hospital, birthing center, medical practice, and individual medical provider. The purpose of such a disclosure is for the public to be able to make a decision about hiring a provider based on the knowledge of their practice standards. Third, a focus on mother-friendly care would place the highest priority of care on the best possible outcome for the mother and newborn baby, rather than focusing on what is best for profits and/or timing of the hospital or medical provider. For example, a mother in labor may be pressured to stay in the hospital to be induced into labor if her labor is not progressed sufficiently and there is inadequate space to care for her for the 24-48 hours required for her labor to progress naturally--this is an example of a decision that is made in the interest of profit and convenience.

There are certainly other categories of change that can be pursued in the matter of maternity care during labor and childbirth, but these three are prominent.

Examples of past and current action addressing these three prominent areas of need include these organizations and their actions:

Coalition for Improving Maternity Services (CIMS; www.motherfriendly.org): CIMS is an organization that promotes mother-friendly care through grassroots advocacy and education. The organization has done the following:

• Established a website with links to educational resources for mothers.
• Created a community of supporting professional that ratify and promote mother-friendly care.
• Hosts a yearly conference with speakers who are prominent in the field and roundtables for promoting ideas within the advocacy of the organization.
• Supports the Birth Survey, which is a project that promotes transparency in maternity care by collecting data from mothers about care providers and environments in order to share it with other expectant mothers via the internet.

Lamaze International (www.lamaze.org): Lamaze is an organization that is well known for its childbirth education classes. However, they are presently much more involved in advocating for mother-friendly care in the following ways:

• The organization maintains a website with links to informative articles and resources for pregnant women.
• Lamaze publishes the Journal of Perinatal Education, a peer-reviewed publication that reports on research related to mother-friendly care (such as this collection of evidence-based information co-produced with CIMS).
• Lamaze has established and publicized its
• Lamaze presents multiple national seminars, conventions, webinars, and educational trainings for childbirth professionals throughout the year.
• Lamaze has established itself as a leader in childbirth advocacy with Position Papers, promoting mother-friendly birth.
• Lamaze has an intricate network of online communities, including bloggers, Twitter pages, Facebook groups, and discussion boards (such as Henci Goer's forum) to help connect the community in cyberspace.
• Most prominently, Lamaze has established its Six Lamaze Healthy Birth Practices that outline the basis for evidence-based, mother-friendly care during labor and birth.

Birth Network National (www.birthnetwork.org): Birth Network National is a relatively young organization that developed as a result of the work of organizations such as Lamaze and CIMS. This organization has:

• A network of local chapters that meet in each community to promote the practice of mother-friendly care in each area.
• Fund-raising and awareness events, such as the Red Tent Event, that are encouraged and promoted through the national organization in individual communities.
• Created a template for birth activism ideas, with both national and local support to help initiate them, that can actually be implemented at the grassroots level.