MATERNAL

FRIENDLY
SERVICES
Dr. Soon Ruey
Sabah Women and Childrens Hospital
Kota Kinabalu
Sabah

Maternal Friendly Services

New criteria for BFHI hospitals
Towards ensuring evidence based
practices used for supporting
mothers and towards ensuring
initiation and continuation of breast
feeding practice

Evidence Based

Allowing mothers to have support

and evidence based care and adequate SOP

Avoiding Overcrowding and lack of Privacy

Avoid Dangerous Practices

Remove Barriers to Information and Access

To Care

Ensuring Continuity of Care and Adequacies

Supplies and Medication

Maternal Friendly Services

- Principles
Birth is a normal, natural healthy process
Empowerment of the women
Confidence and improvement of birth outcome

Autonomy
Involvement in decision making Birth plans?
Ensure a satisfactory birthing experience
In an environment that she chooses
To be educated / be aware of full range of services
Types of pain relief, mode of deliveries.

Receive support for informed choices that she

makes.

 Do no harm
Interventions should not be applied routinely (eg
episiotomies for all primigravidas, barium enemas etc)
Excessive investigations, setting up of unnecessary
lines / branulas
Practice evidence based medicine

Responsible caregiver
Provide quality care
Practices should not be based on the needs of the
provider/caregiver but on the needs of the mother
Periodic audit
Ensuring adequate and equitable access
Providing informed choices

MATERNAL FRIENDLY
CHILDBIRTH INITIATIVE

MFCI
Company Logo

Ten Steps of Mother Friendly

Childbirth Initiative
1. Offers all birthing mothers
unrestricted access to a birth companion of her choice
unrestricted access to continuous emotional and
physical support from a skilled women (doula)
Professional midwifery care

2. Provides accurate descriptive and statistical

information to the public about its practices and
birth care
3. Provides culturally competent care
4. Provides the birthing women freedom to move
about in labour and to assume her position of
choice during birth (unless medically
contraindicated)

5. Has clearly defines policies and procedures for

antenatal care, delivery and postnatal care
6. Does not routinely employ practices and
procedures that are unsupported by scientific
evidence
Shaving
Enemas
Unnecessary infusions / branulas
Early rupture of membranes
Unnecessary fetal monitoring
Induction rate of less than 10% / episiotomy rate of 20%
or less / LSCS rate of less than 10% in community
hospitals and less than 15% in referral hospitals / VBAC
rates in excess of 60%

7. Educate staff on non-drug methods of pain relief

music, self hypnosis, TENS (trans cutaneous nerve
stimulation), warm baths, back massage etc
8. Encourage all mothers and families including those
with sick and premature babies or those with congenital
abnormalities to touch, hold, breastfeed and care for
their babies where possible.
9. Discourages non-religious circumcision of the
newborn
10. Strives to achieve the WHO-UNICEF Ten Steps of
the Baby Friendly Hospital Initiative to promote
successful breastfeeding.

BFHI ASSESSMENT &

MOTHER FRIENDLY
SERVICES

Company Logo

Review of Written Materials

1C Question 5 & 6
Q5 : Looking at protocols and standards related to
breastfeeding, infant feeding and other maternity services in
line with BFHI standards and current evidence based guidelines
Q6 : Written Hospital Policies on mother/ baby friendly labour
and birthing practices
Companion of choice
Allowing light foods and drinks if desired
Encouraging women to consider non drug methods of pain relief
Encourage women to walk / move about during labour and assume
position of choice for delivery unless contraindicated
Care that does not involve invasive procedures such as early ARM,
routine episiotomies, unwarranted acceleration or induction of labour/
instrumental deliveries or Caesarean sections
WHO requirements 4 out of 5 policies are covered adequately
KKM : may be more lenient between 2 or 3 of the 5 policies

THANK YOU
Company Logo