Having a Baby?
10 Questions to Ask
Have you decided how to have your baby? The choice is yours!
First, you should learn as much as you can about al your choices.
• They should not do an episiotomy (ee-peezee-AH-tummy) on
There are many different ways of caring for a mother and her baby
more than 1 in 5 women (20%). They should be trying to bring
during labor and birth.
that number down. (An episiotomy is a cut in the opening to the
vagina to make it larger for birth. It is not necessary most of the
Birthing care that is better and healthier for mothers and babies
is cal ed “mother-friendly.” Some birth places or settings are more
mother-friendly than others.
• They should not do C-sections on more than 1 in 10 women
(10%) if it’s a community hospital. The rate should be 15% or
A group of experts in birthing care came up with this list of 10
less in hospitals which care for many high-risk mothers and
things to look for and ask about. Medical research supports al of
these things. These are also the best
ways to be mother-friendly.
A C-section is a major operation
in which a doctor cuts through the
When you are deciding where to have
mother’s stomach into her womb and
your baby, you’l probably be choosing
removes the baby through the opening.
from different places such as:
Mothers who have had a C-section can
• birth center,
often have future babies normal y. Look
• hospital, or
for a birth place in which 6 out of 10
• home birth service.
women (60%) or more of the mothers
who have had C-sections go on to have
Here’s what you should expect, and ask
their other babies through the birth
for, in your birth experience. Be sure to
find out how the people you talk with
handle these 10 issues about caring
for you and your baby. You may want
Ask, “How do you allow for
to ask the q
tals, and ho 1
uestions below to help you
o can be with me
es in culture and
Mother-friendly birth centers, hospitals,
and home birth services are sensitive
bor and birth?”
to the mother’s culture. They know that
mothers and families have differing
dly birth centers, hospi-
beliefs, values, and customs.
me birth services wil let
a birthing mother decide whom she
For example, you may have a custom
wants to have with her during the birth.
that only women may be with you during
This includes fathers, partners, children, other family members, or
labor and birth. Or perhaps your beliefs include a religious ritual to
be done after birth. There are many other examples that may be
very important to you. If the place and the people are mother-friend-
They wil also let a birthing mother have with her a person who has
ly, they will support you in doing what you want to do. Before labor
special training in helping women cope with labor and birth. This
starts tell your doctor or midwife special things you want.
person is cal ed a doula or labor support person. She never leaves
the birthing mother alone. She encourages her, comforts her, and
helps her understand what’s happening to her.
Ask, “Can I walk and move around during labor?
They wil have midwives a
mother can have a midwif
birth in your setting
If they give mother-friendl
every part of the birthing 2
s part of their staff so that a birthing
What position do yo
e with her if she wants to.
Ask, “What happens during a normal labor and
u suggest for birth?”
In mother-friendly settings, you can walk around and move about
as you choose during labor. You can choose the positions that are
most comfortable and work best for you during labor and birth.
(There may be a medical reason for you to be in a certain posi-
tion.) Mother-friendly settings almost never put a woman flat on her
y care, they wil tel you how they handle
back with her legs up in st
process. For example, how often do they
give the mother a drug to speed up the birth? Or do they let labor
and birth usual y happen on its own timing? They wil also tel you
how often they do certain procedures. For example, they wil have
a record of the percentage of C-sections (Cesarean births) they do
every year. If the number is too high, you’l want to consider having
your baby in another place or with another doctor or midwife.
Here are numbers we recommend you ask about.
irrups for the birth.
Ask, “How do you make sure everything goes
smoothly when my nurse, doctor, midwife, or
agency need to work with each other?”
Ask, “Can my doctor or midwife come with me if I have to be
moved to another place during labor? Can you help me find people
or agencies in my community who can help me before and after
• They should not use oxytocin (a drug) to start labor for more
the baby is born?”
than 1 in 10 women (10%).
continued on next page
Mother-friendly places and people wil have a specific plan for
Ask, “How d
keeping in touch with the other people who are caring for you.
They wil talk to others who give you birth care. They wil help
you find people or agencies in your community to help you. For
example, they may put you in touch with someone who can help
vices support breas1
o you hel
p mothers who want to
The World Health Organization made this list of ways birth ser-
you with breastfeeding.
Ask, “What things d
Experts say some metho
ter and healthier for moth 6
• They tel al pregnant mothers why and how to breastfeed.
• They help you start breastfeeding within one hour after your
o you normally do to a woman
baby is born.
• They show you how to breastfeed. And, they show you how to
keep your milk coming in even if you have to be away from your
ds of care during labor and birth are bet-
baby for work or other reasons.
ers and babies. Medical research shows
us which methods of care are better and healthier. Mother-friendly
• Newborns should have only breast milk. (However, there may
settings only use methods that have been proven to be best by
be a medical reason they cannot have it right away.)
• They encourage you and the baby to stay together al day and
Sometimes birth centers, hospitals, and home birth services use
al night. This is cal ed “rooming-in.”
methods that are not proven to be best for the mother or the baby.
• They encourage you to feed your baby whenever he or she
For example, research has shown it’s usual y not helpful to break
wants to nurse, rather than at certain times.
the bag of waters.
• They should not give pacifiers (“dummies” or “soothers”) to
Here is a list of things we recommend you ask about. They do not
help and may hurt healthy mothers and babies. They are not prov-
en to be best for the mother or baby and are not mother-friendly.
• They encourage you to join a group of mothers who breastfeed.
They tel you how to contact a group near you.
• They should not keep track of the baby’s heart rate all the time
with a machine (called an electronic fetal monitor). Instead, it is
• They have a written policy on breastfeeding. Al the employees
best to have your nurse or midwife listen to the baby’s heart from
know about and use the ideas in the policy.
time to time.
• They teach employees the skil s they need to carry out these
• They should not break your bag of waters early in labor.
• They should not use an IV (a needle put into your vein to give
Would you like to give this information to your doctor,
• They should not tel you that you can’t eat or drink during labor.
midwife, or nurse?
• They should not shave you.
This information is taken from the Mother-Friendly Childbirth Initia-
tive written for health care providers. You can get a copy of the
• They should not give you an enema.
Initiative for your doctor, midwife, or nurse by mail, e-mail, or on
A birth center, hospital, or home birth service that does these
things for most of the mothers is not mother-friendly. Remember,
these should not be used
Ask, “How do you h
able as they can be
help mothers reliev
The people who care for y
with labor. They should kn7
without a special medical reason.
To Get a Copy by Mail
For a copy of both this brochure and the Mother-Friendly Childbirth
Initiative by mail, send a stamped, self-addressed envelope with
elp mothers stay as comfort-
$5 (US) to help cover the costs ($6 Canada or Mexico, $10 al oth-
? Besides drugs, how do you
ers). Bulk prices are available. Mail to:
e the pain of labor?”
Coalition for Improving Maternity Services
ou should know how to help you cope
1500 Sunday Drive, Suite 102
ow about ways of dealing with your pain
Raleigh, NC 27607
that don’t use drugs. They should suggest such things as chang-
ing your position, relaxing in a warm bath, having a massage and
using music. These are cal ed comfort measures.
To Get a Copy on the Internet
Log on to to www.motherfriendly.org
Comfort measures help you handle your labor more easily and
help you feel more in control. The people who care for you wil not
try to persuade you to use a drug for pain unless you need it to
take care of a special me
Ask, “What if my ba
Mother-friendly places an
families to touch, hold, br
much as they can. They w8
dical problem. Al drugs affect the baby.
Tel: 888-282-CIMS (2467) • Fax: 919-787-4916
by is born early or has special
© 2000 Coalition for Improving Maternity Services (CIMS).
Permission granted to freely reproduce in whole or in part along
d people wil encourage mothers and
with complete attribution.
eastfeed, and care for their babies as
Photo courtesy of Lesley Mason | www.newlifephoto.net
il encourage this even if your baby is
born early or has a medical problem at birth. (However, there may
be a special medical reason you shouldn’t hold and care for your
Ask, “Do you circumcise babies?”
Medical research does no
It is painful and risky. Mot 9
t show a need to circumcise baby boys.
her-friendly birth places discourage cir-
cumcision unless it is for religious reasons.
Making Mother-Friendly Care a Reality