The Coalition for Improving Maternity Services has put together a Mother-Friendly Childbirth Initiative (www.motherfriendly.org/MFCI/) that does a good job of sketching out the issues and offers Ten Steps of Mother-Friendly Care www.motherfriendly.org/MFCI/steps/).

Here’s the gist of MFCI’s argument:

In spite of spending far more money per capita on maternity and newborn care than any other country, the United States falls behind most industrialized countries in perinatal morbidity and mortality, and maternal mortality is four times greater for African-American women than for Euro-American women.

Midwives attend the vast majority of births in those industrialized countries with the best perinatal outcomes, yet in the United States, midwives are the principal attendants at only a small percentage of births.

Current maternity and newborn practices that contribute to high costs and inferior outcomes include the inappropriate application of technology and routine procedures that are not based on scientific evidence.

The current maternity care system in the United States does not provide equal access to health care resources for women from disadvantaged population groups, women without insurance, and women whose insurance dictates caregivers or place of birth.

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.