Introducing The International Childbirth Initiative

The International Childbirth Initiative (ICI): 12 Steps to Safe and Respectful MotherBaby-Family Maternity Care is a facilitating and learning network that unites all persons, parties and organizations with a common goal to improve maternity care- defined as the entire scope of care provided by health care providers to woman and babies during pregnancy, birth and the postnatal period. The ICI is a response to inequitable and inappropriate health care services and it introduces an achievable step-by-step guide that promotes excellence in all aspects of childbearing care provision. The ICI was developed as a collaborative response to a call from women, their partners and health care providers all over the world for optimal maternity care that recognizes safe and respectful childbirth as a basic human right in any setting and in any circumstance.  It is built upon previous initiatives and synthesizes and aligns much of the current work being carried out by many organizations active in maternal, newborn and child health. 

Why the Initiative?  

The evidence behind the concepts of ‘Too little Too Late’ and ‘Too Much Too Soon’ (Lancet publication 2016) have shown that quality improvement in maternal care provision is needed in all settings. We know that quality of care is based on good evidence but this alone is not enough. We also know that quality of care means providing the services that women believe they need for themselves and their children. Women want a safe and respectful environment that guarantees their privacy. They want compassionate care providers who listen to them and speak their language (literally and figuratively). They want unbiased and understandable information and encouragement to make their own choices; for themselves, for their children and for their families. Although there are laws and legislation to protect women’s rights worldwide, these rights are being flouted and denied, not only in low income settings, but also in high income countries.  Too often, the most vulnerable groups of women (young, migrant, poor) are the recipients of poor quality care. Too often, women and their children are denied care because they are unable to pay for services. There are striking differences in good health outcomes for mothers and newborns between socioeconomic, racial and ethnic backgrounds. This is unacceptable. All women, wherever they live, should benefit fully from quality maternity care at any time and in any place. 

What the Initiative does 

The ICI provides guidance, support and shared learning for the global implementation of the 12 Steps for Safe and Respectful Maternity Care. It also provides a unified framework for quality improvement around which all organizations could rally to promote safe, respectful, and value-based maternity care. The ICI believes that the 12 Steps implementation can be measured and monitored using basic performance indicators combined with a minimum data collection package in a practical, self-reflective, and low-cost quality improvement cycle that is locally driven, with community involvement, and with a global platform for training, sharing, and learning. 

  • The ICI offers a framework for the provision of safe care in a warm respectful environment, placing women’s autonomy and informed decision making and choices as a first principle. 
  • The ICI unites health professionals together with women’s and community organizations in a unique partnership to not only promote MotherBaby-Family centered care but to implement steps that will transform how we address inequities in birth facilities around the world. 
  • The ICI facilitates a global community of learning for a continuing and sustainable quality improvement cycle that is practical, self-reflective, and low-cost, and locally-driven with community involvement.  


The ICI is grounded in its Foundational Principles which include:  a) Rights, equity, and access to respectful care; b) the MotherBaby-Family triad; c) Wellness, prevention, and timely emergency care; d) Women’s autonomy and a positive birthing experience; e) Caregiver’s responsibility to provide a healthy and positive birthing environment.  

ICI further promotes a MotherBaby-Family centred, evidence and value-based maternity care model acknowledging the MotherBaby unit, the importance of family inclusion and the influence of interactions with health care providers and health systems on the health and wellbeing of the MotherBaby-Family unit. ICI also supports a process of setting-specific implementation, self-reflective evaluation and a process of recognition which involves multidisciplinary and multisectoral engagement and involvement, recognizing the important roles of health providers’ organizations, civil society, educators, policy makers, health managers, and UN organizations.

ICI: FIGO Working Group

The current president of the Federation of Gynecology and Obstetrics has taken the ICI on as a FIGO Presidential Initiative for his term and the ICI has gained status as a FIGO Working Group. The FIGO head office will administer finances and their charity status will apply to funding and donations for the initiative.

Contact the ICI