It has been apparent for some time that the medical care that childbearing women receive is not always in their own or newborn's best interest. Medical care may be state-of-the-art, but may not meet a woman's social, emotional or cultural needs. Although individual caregivers strive to provide what they believe to be the best care for childbearing women, the medical system in which they provide that care may not always make that possible.

Care for childbearing women is often influenced by other factors: outmoded routine medical practices; caregivers' fear of malpractice suits; directives imposed on physicians or hospitals by insurance companies or health maintenance organizations (HMO's); lack of adequate staffing or financial resources; high costs of medical care; financial agreements between caregivers and the medical industry; the marketing of medical technology before adequate testing has been completed; disagreements among caregivers about what constitutes the best care, or simply a lack of interest or will to change the status quo.

The Mother-Friendly Childbirth Initiative, the first consensus initiative of the Coalition for Improving Maternity Services supports woman-centered, evidence-based care.

Mothers-to-be are encouraged to become actively involved in their own maternity care; to ask questions, express their concerns, obtain social support, and find caregivers that best meet their own needs.

To encourage women to become involved in their care, the Coalition for Improving Maternity Services (CIMS) has developed a mother-friendly pamphlet, “Having a Baby? Ten Questions to Ask.” You are encouraged to read it, reproduce it (with appropriate credit) and share it with as many people as you wish.