Mother-Friendly Hospital Policy

1. It is a natural right for expectant mothers to receive safe, effective, and healthy pregnancy monitoring and childbirth services.
2. The services provided should include pre-pregnancy counseling, pre- and post-natal care, and counseling services.
3. The environments where education, outpatient counseling, and childbirth services are provided in our hospital should be prepared in accordance with standards.
4. Privacy expectations should be carefully met, and hygiene and comfort standards should be kept high.
5. Interventions not based on evidence should not be routinely applied.
6. Human resources and logistical support necessary for service delivery should be at an optimum level.
7. Referral criteria should be followed in emergency obstetric situations.
8. Childbirth services should be mother and baby-centered.
9. Activities aimed at strengthening the knowledge and skill capacity of service providers should be planned and implemented.
10. Statistical analyses should be conducted, and their results evaluated.

General Principles of Our Hospital in the Mother-Friendly Hospital Rules
As Istanbul Training and Research Hospital, our main goal is to increase the quality and quantity of our maternal health services and to ensure that expectant mothers have access to safe and high-quality childbirth services.

Normality of labor, safe and high-quality pregnancy monitoring,
Empowerment, prenatal care and prenatal and postnatal counseling services,
Autonomy,
Compliance with non-maleficence and emergency referral criteria,
Responsibility, services being mother and baby-focused,
Providing logistical support and uninterrupted service to all mothers giving birth,
Respect for privacy,
Monitoring and providing information on statistics, ensuring that outpatient clinics, education and counseling services are in compliance with standards,
Avoiding the routine application of non-evidence-based practices,
Promoting successful breastfeeding,
Procedures aimed at increasing the mother's knowledge and skill capacity.

Mother-Friendly Hospital Program

The aim of the program is to improve the quality and quantity of maternal health services, ensuring that expectant mothers have access to safe and high-quality childbirth services.

The program is based on creating private, single-room "Birthing Units" that are friendly to mothers, babies, and families. The goal is to encourage natural childbirth and reduce intervention rates. Pregnant women should feel comfortable and at home with a suitable companion, and should have freedom of movement.

The published Mother-Friendly Hospital Criteria are as follows:

1. It is a natural right for expectant mothers to receive safe, high-quality pregnancy monitoring and childbirth services.

In providing these services, the expectant mother's culture and traditions should be respected, her privacy and autonomy should be valued, and the focus should be on the mother and baby.
Prenatal and postnatal follow-ups should be conducted in accordance with written follow-up protocols prepared according to current scientific criteria.

2. The services provided should include pre-pregnancy counseling, prenatal and postnatal care, and counseling services.

Expectant mothers should be able to contribute to the planning of their birth.
Expectant mothers and their relatives should be informed about different types of childbirth, their potential benefits and risks, and the services provided, including medications, examinations, and interventions, should be presented within a service model that prioritizes accurate information about the benefits and risks for the expectant mother. Materials (written, visual, models, etc.) providing information about pregnancy and childbirth should be available to expectant mothers and their relatives.
When providing prenatal care and counseling services, an "Informed Consent Form" should be read and signed.

3- Institutions should prepare environments for outpatient clinics, education, counseling, and childbirth services in accordance with standards.

Institutions should consist of units that can provide 24/7 service and are organized according to the needs of mothers and babies.
Maternity units should be classified through national inspections, and institutions should be responsible for the quality of care they provide.
They should have a sufficient number and quality of healthcare personnel who provide individual attention to each pregnant woman and maintain good communication with them. Institutions should take the necessary precautions regarding safe blood transfusions and hospital infections.

4- Privacy expectations must be carefully met, and hygiene and comfort standards must be kept high.

The pregnant woman should be able to accept a suitable companion of her choice so that she can feel comfortable and at home.
Physical and emotional support should be provided to the pregnant woman on the wards on a one-to-one basis and easily accessible.
There should be no position restrictions during labor; she should be able to lie in any position she wants, walk and move freely in the room.
Mothers should be encouraged to push in active positions to facilitate delivery.

5-Interventions that are not evidence-based should not be routinely applied.

Nutrition and fluid intake should not be interrupted.
Procedures such as enemas and shaving should not be routinely applied.
Early amniotomy, frequent digital rectal examinations, and urethral catheterization should not be performed.
The institution's cesarean section rate should not exceed acceptable minimum and maximum levels.
6- Human resources and logistical support necessary for service delivery should be at an optimal level.

Prenatal, delivery, and postnatal services should be provided by a well-equipped team using a multidisciplinary approach.
There should be an action plan for approaching high-risk pregnancies.
Birth analgesia services should be available to patients who request them.

7- Referral criteria should be followed in emergency obstetric situations.

Continuity should be ensured in the management of prenatal, delivery, and postnatal services.
Pregnant women presenting with complications related to pregnancy, childbirth, and the postpartum period should be immediately admitted, and the necessary medical intervention should be provided without delay.
The patient should be referred after stabilization.
Referrals should be made by contacting 112 (emergency services).
The referring institution should provide feedback to the referring institution regarding the cases.

8- Birth services should be mother and baby-focused.

Baby-Friendly Hospital criteria should be met.
Mothers and families should be encouraged and supported to hold and touch their newborn babies. Women who have had a vaginal delivery should stay in the hospital for at least 24 hours, and those who have had a cesarean section should stay for at least 48 hours, to receive postpartum care.

9. Activities aimed at strengthening the knowledge and skills of service providers should be planned and implemented.

Continuity of in-service training should be ensured.
Monitoring and evaluation studies should be conducted on the use of Prenatal Care, Emergency Obstetric Care, Labor and Cesarean Section, and Postpartum Care Management Guidelines.
Clinical protocols and flowcharts should be located in the correct unit in a visible place.
Physicians and other healthcare personnel working within the institution should be ensured to adopt and be informed about these principles and guidelines.

Employees should have 24-hour access to reference materials.

10. Statistical analyses should be conducted and their outputs evaluated.

Centers should maintain regular and accurate records of the quality and quantity of services provided electronically.
Statistical data should be published online and made accessible to all institutions and citizens.
Maternal and perinatal mortality and morbidity should be carefully monitored, and regular feedback meetings should be held for this purpose.