Mother-Friendly Accreditation Program

Turning maternal healthcare into a conversation rather than a verdict.

"Medicine has a long history of presupposing what is right for our patients, though it is changing. The paradigm had already shifted from the paternalistic model of doctor knows best to one of shared decision making by the time I reached medical school. But the new construct still weighted the doctors’ recommendations heavily. As young physicians we were taught we possessed knowledge that would allow us to delineate the possible paths for our patent and that ultimately the choice was theirs to make.

Implicit in this was that there remained one best choice and if the patient didn't select that choice, perhaps you hadn't done the best possible job selling them on it.

It’s impossible to be agenda-less when one believes that one knows what’s best. 

We weren't trained to value the patients story. To listen to our patients with a generous ear does require a willingness to relinquish control of the narrative, and like all loss of control, there is an element of risk involved and risk carries with it an inherent degree of vulnerability."excerpt from In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope

The medical system trains providers to ask questions that steer people to a destination. They aren't trained to listen and cultivate relationships through trust and disclosure and far too often, because of this construct, an unnecessary power struggle ensues when pregnant families work to make choices they feel are best for them.

Before the information age, this may have been the best course of action but now families have the best research and knowledge available at their finger tips. It is far time to rethink how we communicate with each other during care.

It is said that the most dangerous phrase in the English language is "We've always done it this way".

Why This Matters

In addition to these deeply rooted communications issues, there are equally rooted outdated practice patterns that we know can cause harm. Often, when numbers and statistics are reviewed, it fails to consider the emotional well-being of the people giving birth. Patients can suffer at varying degrees from trauma caused by these often fear based and outdated practice patterns.

The quality of maternity care in the United States  has produced some of the worst maternal health outcomes among all other developed countries, despite spending far more.

One in every three women has major abdominal surgery during birth and more than 40% of hospitals have mandatory surgery policies for women with prior cesareans, contrary to current evidence and national guidelines.

In addition to that, as many as 70% of women experience interventions to start or speed up labor, often without medical indication. These interventions are often unnecessary and unwanted and research has proven that this has not resulted in better outcomes for mothers or their newborn.

We know that there is a better way, not just for the patient, but the provider as well. No one is going into a birth with the intention of being hurt or hurting.

A New Way

Mother-Friendly Accreditation Program (MFAP) is for hospitals and providers intent on improving communications and the quality of care for the pregnant families they serve, with a goal of improving outcomes and reducing their cesarean and intervention rates.

The MFAP offers a clear road map that guides providers and staff towards a more current and patient center care model.

Carrying the Mother-Friendly seal will allow hospitals and providers to become the beacon in their community and the leading choice for families who want exceptional facility based maternity care.

Mother-Friendly is about creating reassurance and peace of mind that pregnant people are putting their body, their baby and their family in the hands of someone they can trust.

Not Just a Rubber Stamp

When a doctor or facility applies for Mother-Friendly Accreditation, they are committing to continuing education and a shift from the current fear based system, to a culture focused around collaborative, patient centered care.

Pilot Program

Mother-Friendly is currently in the first stage of its pilot program, beginning with three "Alongside Centers" launching in the spring of 2018. By the first quarter of 2019 we anticipate the addition of at least four more pilot locations, including a minimum of two standard labor and delivery units.

Mother-Friendly Alongside Center:

Alongside centers are distinctly separate from standard labor and delivery services with midwives as the primary care provider. These units support low-risk patients and families who wish for a more home like environment and desire a little to no intervention childbirth experience.

Measurable Standards and Indicators

The Mother-Friendly Accreditation Program has 53 measurable standards developed first based on the Commission for the Accreditation of Birth Centers measures. These measures were then combined with the original Mother-Friendly Childbirth Initiative - 10 Steps to become Mother-Friendly, developed by the Coalition for Improving Maternity Services.

Benefits to Mother-Friendly Accreditation

The Mother-Friendly Accreditation Program offers goal setting, policy and procedure review, peer-to-peer instruction, and a robust Continuous Quality Improvement program for support staff and providers.

Goal Setting

The American maternity care system is seeing enormous pressure to reduce cesarean rates, intervention rates and improve maternal morbidity and mortality. MFAP helps providers and hospitals set goals and track progress.

Policy and Procedure Review

MFAP reviews and develops policies and procedures that support the Mother-Friendly model of care, enhance risk management, and allow hospitals to provide evidence-based maternity care.

Peer-to-Peer Instruction

The MFAP provides instruction and guidance from experienced experts in maternal health who teach through presentation, demonstration and consumer based storytelling.

Instruction includes:

Cultural Sensitivity
VBAC as a reasonable option for most
Informed Consent
Evidence Based Care
Quality Care Improvements
Specifics: the long term risk of cesarean and induction, supporting for the full 42 weeks, understanding the microbiome, breech delivery, etc.

Continuous Quality Improvement

The Continuous Quality Improvement program will allow hospitals to recognize any quality issues quickly and systematically work to resolve issues in order to assure that they provide the very best maternity care.

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When I say I do not like war, it does not mean I dislike soldiers. When I critique the current state of our education system. it does not mean I dislike teachers/educators. When I am critical about the U.S. maternity care system, it does not mean I dislike nurses/providers/hospitals.

Without critique there will be no change.

- Amanda Hardy, PhD.

Help Make a Difference


Your financial support is vital. Your contribution will help us complete the curriculum with an emphasis on cultural and behavior change. We can't tackle this massive issue with just numbers and slides. We must tell the stories of how the current system is doing harm and how we can change that together.
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