The Mother-Friendly Childbirth Initiative

The Mother-Friendly Childbirth Initiative (MFCI), drafted in 1996, was an evidence-based consensus document ahead of its time. Since then, research, professional guidelines, state–wide health care directives, hospital systems, health care quality improvement initiatives, and federal and state-level maternity care legislation have identified many aspects of the MFCI and the Ten Steps of the Mother-Friendly Childbirth Initiative as key factors to improving maternal-infant health outcomes. This document, updated in 2015, provides the evidence to show that the MFCI can be used as a guide to meet professional and federal guidelines to make childbirth safer, less costly, and more satisfying to childbearing women and their families.

These principles gave rise to the 10 steps of the Mother-Friendly Childbirth Initiative:

We believe the philosophical cornerstones of Mother-Friendly care to be as follows:

Normalcy of the Birthing Process

  • Birth is a normal, natural, and healthy process.
  • Women and babies have the inherent wisdom necessary for birth.
  • Birth can safely take place in hospitals, birth centers, and homes.
  • The midwifery model of care, which supports and protects the normal birth process, is the most appropriate for the majority of women during pregnancy and birth.
  • Babies are aware, sensitive human beings at the time of birth, and should be acknowledged and treated as such.
  • Breastfeeding provides the optimum nourishment for newborns and infants.


  • A woman’s confidence and ability to give birth and to care for her baby are enhanced or diminished by every person cares for her and by the environment in which she gives birth.
  • A mother and baby are distinct yet interdependent during pregnancy, birth and infancy. Their interconnectedness is vital and must be respected.
  • Pregnancy, birth, and the postpartum period are milestone events in the continuum of life. These experiences profoundly affect women, babies, fathers, and families, and have important and long-lasting effects on society.

Every woman should have the opportunity to:

  • Have a healthy and joyous birth experience for herself and her family, regardless of her age or circumstances;
  • Give birth as she wishes in an environment in which she feels nurtured and secure, and her emotional well-being, privacy and personal preferences are respected;
  • Have access to the full range of options for pregnancy, birth, and nurturing her baby, and to accurate information on all available birthing sites, caregivers and practices;
  • Receive accurate and up-to-date information about the benefits and risks of all procedures, drugs and tests suggested for use during pregnancy, birth and the postpartum period, with the rights to informed consent and informed refusal;
  • Receive support for making informed choices about what is best for her and her baby based on her individual values and beliefs.

Do No Harm

  • Interventions should not be applied routinely during pregnancy, birth or the postpartum period. Many standard medical tests, procedures, technologies, and drugs carry risks to both mother and baby and should be avoided in the absence of specific scientific or medical indications for their use.
  • If complications arise during pregnancy, birth or the postpartum period, medical treatments should be evidence-based.


  • Each caregiver is responsible for the quality of care she or he provides.
  • Maternity care practice should be based not on the needs of the caregiver or provider, but solely on the needs of the mother and child.
  • Each hospital and birth center is responsible for periodic review and evaluation according to current scientific evidence, of the effectiveness, risks and rates of use of its medical procedures for mothers and babies.
  • Society, through both its government and the public health establishment, is responsible for ensuring access to maternity services for all women and for monitoring the quality of those services.
  • Individuals are ultimately responsible for making informed choices about the health care they and their babies receive.

To execute CIMS’ vision of “Mother-Friendly” maternity care, a hospital, birth center or home birth service must fulfill the Ten Steps of Mother-Friendly Care.
Click here to read and endorse the Mother Friendly Childbirth Initiative on the Coalition for Improving Maternity Services (CIMS) website.

Downloadable File: 

PDF iconCIMS%27 Mother-Friendly Childbirth Initiative (2015).pdf

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