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The Rights of Childbearing Women
Revised, 2004
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The Rights of Childbearing Women
This statement outlines a set of basic
maternity rights that Childbirth Connection has identified and promotes
for all
childbearing women. It applies widely accepted human rights to the
specific situation of maternity care. Although most of these rights are
granted to women in the United States by law, many women do not have
knowledge of their maternity rights. Consideration and respect for
every woman
under all circumstances is the foundation of this statement of rights,
available as a printed piece for educational and advocacy settings, as
a downloadable PDF, and on this page.
For
one free brochure, send a self-addressed stamped envelope (SASE) to: Childbirth
Connection Attn: Rights Statement 281 Park Avenue South, 5th Floor New York, NY 10010.
Re-Publishing Terms
If you would like to link to the PDF version of this statement of
rights, or republish these rights in a print format, please visit our Contact Us page to request written permission. If you would like to distribute this brochure to clients, patients, or other interested parties, please visit our bookstore to purchase a bundle of 50 brochures for $12. Each additional bundle of 50 is $6.
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Fundamental Problems with Maternity Care in the United States
This statement was developed in response to serious and continuing problems with maternity care in the United States, including:
- The United States is the only wealthy industrialized nation that
does not guarantee access to essential health care for all pregnant
women and infants. Many women, especially those with low incomes, lack
access to adequate maternity care.
- A large body of scientific research shows that many widely used
maternity care practices that involve risk and discomfort are of no
benefit to low-risk women and infants. On the other hand, some
practices that clearly offer important benefits are not widely
available in U.S. hospitals.
- Many women do not receive adequate information about benefits and
risks of specific procedures, drugs, tests, and treatments, or about
alternatives.
- Childbearing women frequently are not aware of their legal right to
make health care choices on behalf of themselves and their babies, and
do not exercise this right.
We must ensure that all childbearing women have access to information
and care that is based on the best scientific evidence now available,
and that they understand and have opportunities to exercise their right
to make health care decisions. Women whose rights are violated need
access to legal or other recourse to address their grievances.
The Rights of Childbearing Women
* At
this time in the United States, childbearing women are legally entitled
to those rights.
** The legal system would probably uphold
those rights.
 Every woman has the right to health care before, during and after pregnancy and childbirth.
 Every woman and infant has the right to receive care that is consistent
with current scientific evidence about benefits and risks.* Practices
that have been found to be safe and beneficial should be used when
indicated. Harmful, ineffective or unnecessary practices should be
avoided. Unproven interventions should be used only in the context of
research to evaluate their effects.
 Every woman has the
right to choose a midwife or a physician as her maternity care
provider. Both caregivers skilled in normal childbearing and caregivers
skilled in complications are needed to ensure quality care for all.
 Every woman has the right to choose her birth setting from the full
range of safe options available in her community, on the basis of
complete, objective information about benefits, risks and costs of
these options.*
 Every woman has the right to receive all or
most of her maternity care from a single caregiver or a small group of
caregivers, with whom she can establish a relationship. Every woman has
the right to leave her maternity caregiver and select another if she
becomes dissatisfied with her care.* (Only second sentence is a legal
right.)
 Every woman has the right to information about the
professional identity and qualifications of those involved with her
care, and to know when those involved are trainees.*
 Every
woman has the right to communicate with caregivers and receive all care
in privacy, which may involve excluding nonessential personnel. She
also has the right to have all personal information treated according
to standards of confidentiality.*
 Every woman has the right
to receive maternity care that identifies and addresses social and
behavioral factors that affect her health and that of her baby.** She
should receive information to help her take the best care of herself
and her baby and have access to social services and behavioral change
programs that could contribute to their health.
 Every woman
has the right to full and clear information about benefits, risks and
costs of the procedures, drugs, tests and treatments offered to her,
and of all other reasonable options, including no intervention.* She
should receive this information about all interventions that are likely
to be offered during labor and birth well before the onset of labor.
 Every woman has the right to accept or refuse procedures, drugs, tests
and treatments, and to have her choices honored. She has the right to
change her mind.* (Please note that this established legal right has
been challenged in a number of recent cases.)
 Every woman
has the right to be informed if her caregivers wish to enroll her or
her infant in a research study. She should receive full information
about all known and possible benefits and risks of participation; and
she has the right to decide whether to participate, free from coercion
and without negative consequences.*
 Every woman has the
right to unrestricted access to all available records about her
pregnancy, labor, birth, postpartum care and infant; to obtain a full copy of these
records; and to receive help in understanding them, if necessary.*
 Every woman has the right to receive maternity care that is appropriate
to her cultural and religious background, and to receive information in
a language in which she can communicate.*
 Every woman has
the right to have family members and friends of her choice present
during all aspects of her maternity care.**
 Every woman
has the right to receive continuous social, emotional and physical
support during labor and birth from a caregiver who has been trained in
labor support.**
 Every woman has the right to receive full
advance information about risks and benefits of all reasonably
available methods for relieving pain during labor and birth, including
methods that do not require the use of drugs. She has the right to
choose which methods will be used and to change her mind at any time.*
 Every woman has the right to freedom of movement during labor,
unencumbered by tubes, wires or other apparatus. She also has the
right to give birth in the position of her choice.*
 Every
woman has the right to virtually uninterrupted contact with her newborn
from the moment of birth, as long as she and her baby are healthy and
do not need care that requires separation.**
 Every woman
has the right to receive complete information about the benefits of
breastfeeding well in advance of labor, to refuse supplemental bottles
and other actions that interfere with breastfeeding, and to have access
to skilled lactation support for as long as she chooses to
breastfeed.**
 Every woman has the right to decide
collaboratively with caregivers when she and her baby will leave the
birth site for home, based on their conditions and circumstances.**
� 1999, 2006 Childbirth Connection
Our SourcesThe following sources, in their present or earlier editions, helped guide the development of this statement of rights:
 American Hospital Association. The Patient Care Partnership: Understanding Expectations, Rights and Responsibilities, 2003.
Annas, G..J. A national bill of patients' rights. New England Journal of Medicine 1998;338(10):695-699.
Annas, G. J. The Rights of Patients: The Authoritative ACLU Guide to the Rights of Patients, third edition. Carbondale, IL: Southern Illinois University Press, 2004.
The Boston Women's Health Book Collective. Sections on "Childbearing" and "Knowledge is Power." In: Our Bodies, Ourselves: A New Edition for a New Era. New York: Simon & Schuster, 2005;417-524, 699-758.
Coalition for Improving Maternity Services (CIMS). The Mother-Friendly Childbirth Initiative, 1996.
Enkin, M., Keirse, M. J. N. C., Neilson J., Crowther, C., Duley, L., Hodnett, E. and Hofmeyr, J. A Guide to Effective Care in Pregnancy and Childbirth, third edition. New York: Oxford University Press, 2000.
International Childbirth Education Association, Inc. The Pregnant Patient's Bill of Rights. Minneapolis: ICEA, 1975.
President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry. Appendix A: Consumer Bill of Rights and Responsibilities. In its Quality First: Better Health Care for All Americans.
United Nations. Universal Declaration of Human Rights, 1948.
Thank
you to George Annas, professor and chair of Health Law at the Boston
University School of Public Health, for clarifying the legal status of
the individual rights.
Most recent page update: 11/7/2007
© 2010 Childbirth Connection. All rights reserved.
Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
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News and Features
"2020 Vision" and "Blueprint for Action" Reports Available
Leaders from across the U.S. health care system have prepared several reports for improving the maternity care system.
Learn about Transforming Maternity Care project
Read the "2020 Vision"
Read the "Blueprint for Action"
Read the Consumer Workgroup report
Help implement Blueprint recommendations
Rising Maternal Mortality
Analysis of maternal mortality data for the state of California, with 14% of the nation's births, strongly suggests that maternal mortality is increasing in tandem with rising rates of cesarean section and obesity.
Read article about maternal mortality in California
Read companion Q&A
Maternity Care Fact Sheet Available
A new fact sheet (12/09) summarizes U.S. maternity care trends and figures from the latest federal reports. The fact sheet updates background information in the 2008 Milbank Report on Evidence-Based Maternity Care.
Get the fact sheet
Read Evidence-Based Maternity Care
US Cochrane Center (USCC)/Consumers United for Evidence-based Healthcare (CUE)
Visit the USCC/CUE website for the latest pregnancy and childbirth systematic reviews.
Maternity Care, a Major Segment of Health Industry, Must Be Overhauled for Health Care Reform to Succeed
As competing interests work out the particulars of health care reform, Childbirth Connection reminds the nation that rapid gains in the quality, cost, and value of maternity care are achievable.
Read the press release (PDF)
National Policy Symposium Honors Childbirth Connection's 90th Anniversary
Nearly 250 leaders deliberated about Transforming Maternity Care in Washington DC in April 2009.
Learn about symposium, next steps 
See 90 years of milestones for women and families (PDF)
Seton Family of Hospitals Receives First Maternity Quality Matters Award
Childbirth Connection presented its inaugural Maternity Quality Matters Award to an organization that is achieving significant gains for women and newborns.
Learn more about award winner
Maternity Care Priorities in Health Care Reform
Childbirth Connection has issued a statement about health care reform priorities for a high quality, high value maternity care system.
Read the statement (PDF)
Evidence-Based Maternity Care Report Released
A major new report takes stock of the U.S. maternity care system and finds great opportunities for improvement. Childbirth Connection collaborated with the Reforming States Group and the Milbank Memorial Fund to develop the report.
Learn more, get the report
Read companion USA Today article
Read the USA Today article
Read the Consumer Reports story
Take the Consumer Reports quiz
Read Our Bodies Our Blog entry
Help Transform Maternity Care! Please join our efforts to make quality maternity care a top national priority. Your support will help make the transformation possible. View 2009 Supporter Roster
New Mothers Speak Out National Report ReleasedThe latest report in Childbirth Connection's Listening to Mothers series is now available. Get an eye-opening look at the reality of life as a mother of young children in the United States, based on national surveys conducted by Harris Interactive. Learn more, get the report Read the Wall Street Journal story and listen to the podcast Download Quick Facts (PDF)
"My biggest piece of advice to a mother that is pregnant for the first time is: feel comfortable with your doctor or midwife. And it's definitely ok to change, even at the last minute!"
-Listening to Mothers® survey participant
Every woman and infant has the right to receive care that is consistent with current scientific evidence about benefits and risks. Practices that have been found to be safe and beneficial should be used when indicated. Harmful, ineffective, or unnecessary practices should be avoided. Unproven interventions should be used only in the context of research to evaluate their effects.
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