CIMS is Hard at Work for Mamas on Bedrest

February 25th, 2010

I’m so excited! The Coalition for Improving Maternity Services (CIMS) Annual Meeting and Forum will be held in Austin this weekend, February 26-27th and I’m going to be there!  Some of the most prominent experts in mother and baby care will be presenting and relating data from their latest research. I know that I am going to learn a lot about how to better care for and serve mamas on bed rest. Of course I will be sharing all that I learn with you.

CIMS defines itself as,

“The Coalition for Improving Maternity Services (CIMS) is a coalition of individuals and national organizations with concern for the care and well-being of mothers, babies, and families. Our mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs. This evidence-based mother-, baby-, and family-friendly model focuses on prevention and wellness as the alternatives to high-cost screening, diagnosis, and treatment programs.”

What does CIMS do for Mamas On Bedrest?

“How does this pertain to me? I have a high risk pregnancy and all of those “natural” treatments and birthing options won’t work for me. There will be lots of medical intervention in my birth-there already has been!” CIMS is dedicated to ensuring that all mamas have as natural and as safe a pregnancy, labor and delivery as possible-whether they are considered “high risk” or an “uncomplicated” pregnancy.

Why is CIMS’ work so important?

Mostly because of the poor maternal and infant mortality rates in the United States. According to the March of Dimes 2003 data , infant mortality rates in the US are at approximately 6.8 deaths per 1000 births. This is a sobering number given that in the US, we have some of the most technological treatments available. Despite our technological advances and our ever rising medical costs, the United States lags far behind most industrialized nations and many developing nations in infant mortality. For all we do, many American infants still die well before their first birthdays. The statistics are worse or African American babies. Black babies die at a rate of 13.5/1000 according to the March of Dimes.

Maternal mortality is not much better. According to the US Department of Health and Human Services Health Resources and Services Administration, in 2006 13.3 maternal deaths occurred for every 100,00o births. This may not seem like a lot, but in 1n 1987, that number was 6.6 per 100,000. We’re going backwards, not forwards. What is most alarming to me, an African American woman, is that the vast majority of deaths occur in African American women and babies. African American mothers are 3 times more likely to die from complications of pregnancy or childbirth than their white counterparts.

Part of the problem is that for all of our technology and advanced treatments, they are not readily available to everyone. Women from lower socioeconomic groups, women without insurance  and women whose insurance dictates caregivers or place of birth are at the mercy of whatever care their providers choose to give them.

And in many cases, that means cesarean section. The United States has one of the highest rates of cesarean section delivery in the world. Nearly a full 34% of babies born in the United States are born via cesarean section. While cesarean section is a necessary procedure in certain cases, often in the United States cesarean sections are elected based on convenience or to avoid the potential for a poor outcome and subsequent litigation. The World Health Organization (WHO) clearly states,

“Countries with some of the lowest perinatal mortality rates in the world have cesarean rates of less than 10%. There is no justification for any region to have a rate higher than 10-15%” (From the International Cesarean Awareness Website,

CIMS is working with ICAN and other organizations to push tougher regulations on cesarean sections so that mamas and babies won’t be put at unnecessary risk.

CIMS is also at the forefront when it comes to education, especially regarding breast feeding. It has long been established that breastfeeding is the best way to nourish an infant and has been endorsed by the WHO and the American Academy of Pediatrics. Yet a small percentage of American women and their babies have established breastfeeding by 6 weeks. CIMS’ members work diligently to provide breastfeeding education resources to underserved areas and to assist mamas who want to breast feed to do so.

CIMS is working to change the way American clinicians provide prenatal care to pregnant women. They advocate for the midwifery model of care which sees a woman as the primary driver of her health care and as an active participant in all decisions regarding her prenatal care.

The Mother Friendly Childbirth Initiative (MFCI)

With all of these interests, CIMS has issued The Mother Friendly Childbirth Initiative (MFCI). MFCI clearly states the position of CIMS on maternal, child and family birth and health care and what they are doing to change our current maternal health care system. The entire consensus statement can be read here.

CIMS is not a bunch of loud mouths hippies calling for everyone to have home births, and unfortunately, that is how some of their opponents try to portray them. On the contrary, CIMS is an organization whose members and advocates research pregnancy and child birth while adhering to the most stringent medical research methods currently required.  Any treatment or procedure that they advocate is endorsed because there is clearly defined evidence that the treatment is effective and beneficial and works with minimal or no inhibition to the natural course of pregnancy, labor and delivery. As we all know there are a number of treatments and procedures performed today during the course of “normal” prenatal care, pregnancy, labor and delivery that while they “get the job done,” they are often detrimental to mama and baby either physically and/or emotionally. CIMS raises awareness about such procedures while at the same time advocating for alternatives that are more supportive, nurturing, and equally beneficial and effective for mama and baby.

CIMS is an advocate for safe, natural pregnancies and births. No, they are not going to reem you for being high risk and needing intervention such as bed rest. But they are going to advocate that you be offered all possible options for your situation, that you get the support that you need while you are on bed rest regardless of your economic or insurance situation, that you be allowed to at least try vaginal birth in the absence of an evidence based contraindication, that you be close to your baby as soon as possible after delivery and that you have all the education, assistance  and support that you need to skillfully breastfeed your newborn.

I’ve said it before and I’ll say it again. Being on prescribed bed rest with a high risk pregnancy does not mean that you, a mama on bed rest,  lose all rights to decide your course of care. Nor should it prevent you from receiving the best care for you and your baby; care that supports you, nurtures you and results in both of you. CIMS may advocate for vaginal births and a midwifery model of care, but at its heart, CIMS seeks to defend and advocate for the health and well being of mothers and babies.

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