A Day dedicated to Mother's: Safe Motherhood Quilt Rally

My speech from rally: I am a mother, grandmother, doula, educator, Filmaker and Chair of the International MotherBaby Childbirth Organization. What an honor to be here today with mothers, fathers, grandparents, legislators, elected officials, esteemed colleagues, speakers, all of us  concerned citizens.  As we approach Mothers day I cannot think of a better way to honor our mothers than to hold them dear in our hearts and improve our care for them as they inter motherhood -during childbirth

The way we treat women in birth-- provides an insight into how we care for and respect  women in society.  Childbirth and Breastfeeding shine a light into are our core values for women and our next generation.

Ina May,  I am personally honored to share this platform and path with you. You are our mother of midwifery. Your strength, voice and dedication to speak for those who cannot speak -women who have died in childbirth, as well as to stand for what a respectful quality maternity care system looks like has inspired me and many around the world to speak out and speak up. I hope all of you here today will add your voices and demand improvements in maternity care for all.

While this beautiful quilt is a tribute,  It is also  somber reminder of women who did not have to die in childbirth in America.  It is a call to action so that all women and families of America will have safe, quality, evidence based, respectful care   Much of the emphasis on interventions to reduce maternal and infant mortality and morbidity to date has been clinically focused on the provision of hospital based care, the standard medical model and surgical treatments.  Little attention has  been paid to a  evidenced based model of optimal- respectful- MotherBaby care utilizing midwives as well as, physicians and nurses who practice in a model that supports the inherent physiology of mothers and baby's. We must move beyond our  linear solutions and recognize the inherent complexity of most health care issues. The lack of progress toward both our own Healthy People 2020 goals and the UN Millennium development # 5 to reduce maternal mortality suggests that the provision of maternity care with highly skilled surgeons, while vital  -this approach alone is  not sufficient to reach the  our goals and create a balanced maternity care system.  We must  addresses our overuse of technology and underuse of many highly effective low cost options including birth centers, doulas, freedom of movement eating and drinking and the list goes on. Most Americans don't realize that we offer the least amount of options for comfort then any other developed country.   I have seen first hand  how other countries optimize their care with low tech, high caring support for women.  Research supports that use of these evidence based practices would lead to more safe and healthy births Our complex contextual and inter-personal barriers often restrict appropriate use of resources, technology and interventions including many effective low cost options.

We can improve outcomes and reduce costs.  Of our top 10 health care expenditures in the US 6 are due to maternity care.  We spend more on maternity care than any other country.  We have no excuse for ranking behind 49 other countries in maternal mortality. We have the opportunity together to improve the lives of Mother's and our next generation- while saving our county billions of dollars. . the U S has the dubious honor of one of the few countries globally whose rates of maternal mortality have actual worsened since both goals were established in 2000.   At the same time counties like Brazil have made improvement and are on target to reach their goals.  Even Cuba and Slovenia ranks better than the U S. The coalition for improving maternity service and the international motherbaby childbirth initiative along with our partner organizations,  national and global leaders are addressing this neglected and crucial gap, with a specific emphasis on a newly recognized roadblock to access to care, namely disrespectful and abusive attitudes.

Over the last five years, as series of empirical studies have revealed that disrespectful care and abuse exists in maternity service delivery and that it can be an important obstacle to the desire and willingness of women to access the care they may need around childbearing in hospitals or health clinics, especially in facilities whose clientele is poor and disadvantaged. Indeed, qualitative research suggests that the prevalence of such attitudes and behaviors in some settings may explain much of the gap between initial attendance for antenatal care, and subsequent failure to attend again.  Disrespectful and abusive care (often based on fundamental gender inequalities) also manifests itself in low quality care provision, that is not culturally appropriate, lacks a good evidence base, and that is fragmented between hospital and community, further endangering the lives and wellbeing of women and their babies, and decreasing the attractiveness of working in maternity care settings for trained and skilled staff. This leads to vicious downwards cycles that further perpetuate the problem.

In addition more and more women are suffering post traumatic stress disorder after childbirth with a recent survey by childbirth connection showing 18 % of American woman suffer some of the symptoms of PTSD.  A day that should be transformative, positive, ecstatic - is turning traumatic as well as growing numbers of women are suffering from postpartum depression that we know is triple the risk for woman who have a cesarean and other interventional births. This is a tragedy of our system of epidemic proportion, a tragedy for women, babies, families, community's and society  It is not just about surviving childbirth.  Women deserve safe and healthy births for themselves and their babies that allow them to thrive physically and emotionally.  We must value and protect a woman's emotional well-being and memory of childbirth.  This is a day she will never forget!

We must  as the

The IMBCI Step 1 states:

 Treat every woman with respect and dignity, fully informing and involving her in decision making about care for herself and her baby in language that she understands, and providing her the right to informed consent and refusal.

we must provide “Consideration and respect for every woman as the foundation of all maternity care; establishing a caring atmosphere, listening to the mother, encouraging her self-expression, and respecting her privacy are essential aspects of optimal maternity care;

 We must demand :continuity of care and sensitivity to the mother’s cultural, religious, and individual beliefs and values  to reduce the risk of psychological trauma and enhance women’s trust in their caregivers, their experience of childbearing, and their willingness to accept care and to seek care in the future.”

We must  addresses these crucial roadblock to progress on the improving our outcomes, reducing maternal mortality and morbidity providing Mother-Friendly maternity care

by addressing these crucial contextual and cultural issues that maximize respectful care,  involve the woman in informed decision making about care for herself and her baby including consent and refusal  partnered with quality evidence based maternity and breastfeeding practices, increased access to midwifery care, birth centers, home birth along with hospital and community collaboration--- we will  increase access to appropriate  quality respectful care which will, impact positively on the wellbeing of women and their babies, impact positively on the staff who provide maternity care for them, as well as improve our outcomes .

We have the answers.

Please add your voice to create Mother-Friendly childbirth  and optimal respectful MotherBaby maternity care for all!

www.motherfriendly.org

www.imbci.org