Virtual International Day of the Midwife 2020 conference was held on or about 05 May, depending upon global location. Recordings are at the Virtual Midwives YouTube channel. Thanks to Frontier Nursing University for providing VIDM with access to their video conferencing system: Big Blue Button. Thanks also to the many volunteers who make this conference a success.
Preconference A: WHO guidance on maternal and newborn health during the coronavirus pandemic
Preconference B: Sustaining quality midwifery care in a pandemic and beyond
01. KEYNOTE :: Humanising Childbirth: what can midwives do?
Speaker: Sheena Byrom
Facilitator: Catherine Salam
It is the Year of the Nurse and the Midwife and we are in the midst of a global pandemic. The world is reeling with the consequences of an unstoppable COVID-19 virus spread with reports of growing morbidities and mortalities each day, yet mothers and their unborn and newborn babies continue to need safe, compassionate maternity care. Whilst most childbearing women and their babies are healthy, they may experience clinical, psychological, and social vulnerabilities (Renfrew et al 2020).
In normal circumstances midwifery is acknowledged as the solution for quality maternal and newborn care (Renfrew et al 2014). In addition, midwives have been identified as having an essential role to play in humanitarian settings due to their position in communities, unique knowledge and skills (Beek et al 2019). However, in some parts of the world midwifery led services are being reduced due to various reasons including shortage of midwives (for various reasons) and lack of appropriate transfer systems.
During times of crisis there are greater risks of avoidable harm (Renfrew et al 2020) and in some countries reports are coming through that unnecessary interventions are being imposed such as Caesarean section deliveries and separation of mothers and babies even though international policy and position statement advice the contrary (ICM 2020, RCOG, WHO 2020). These events are in direct opposition to the increasing global movement to humanise childbirth from international policy to the direct contact we have with mothers, babies and families (Newnham et al 2018; Newnham & Page 2020) and it is our duty to challenge the situation.
At the end of this pandemic we are likely to see significant economic downturn where the most vulnerable will suffer the most. We must remember this and direct our attention to maximise the potential for a positive mother-infant connection during the critical time at birth, and early years.
This session will present the above challenges faced by midwives, mothers and families and offer potential solutions to support midwives in their quest to continue to provide optimal, humanised maternity care.
02. Birth Cartography – facilitating communication for enhanced shared-decision making.
Speaker: Catherine Bell
Facilitator: Deborah Davis
Birth Cartography, is a concept for birth preparation. Based on the intention of a birth plan, birth cartography provides a structure for communication between care providers and consumers.
This presentation describes the concept of birth cartography and practical communication processes midwives can incorporate into practice. Presented from a consumer perspective, building empathy and understanding for how women experience birth preparation (particularly the first time).
03. PNG Buddy Program building midwifery leadership and improving maternal and newborn health outcomes in PNG.
Speaker: Ruth King
Facilitator: Cecilia Jevitt
Description: Sharing a story of development and achievement through successful Twinning, as midwives in PNG and Australia with guidance and support from Rotary embark upon a journey to grow and sustain the leadership potential of midwives in PNG. 12 of the anticipated 18 midwives from Australia have already connected with their PNG Buddies leading to increased confidence for leadership, action and advocacy as well as implementation and planning for a number of innovative tangible projects. Because we know that midwifery leadership is vital in addressing the SDG targets for maternal health, sharing the learning from this initiative could assist other low-middle-income countries where it may be applicable.
03. Recomendaciones para la implementación de Habitaciones (LPR) en la atención sostenible del parto respetado. (Spanish)
English: Recommendations for the implementation of LPR rooms in the sustainable care of respectful birth.
Speaker: Carina Salgado
Facilitator: Marcela Mendoza
Fondo: Las habitaciones (LPR) permiten en la mujer de bajo riesgo realizar una labor, parto y recuperación de manera segura respetuosa e intercultural.
Objetivo: Evidenciar los beneficios de la implementación de salas LPR en las unidades de salud hospitalaria.
Desarrollo: Las habitaciones sin tecnología llena de aditamentos para el parto respetado como, por ejemplo; camas de casa arcos de madera donde cuelgan rebozos, bancos de parto, agradan al 100% de las usuarias, permiten la privacidad, evolucion del nacimiento fisiológico y mejor cumplimiento de las recomendaciones de las 56 recomendaciones OMS/OPS para el parto respetado de bajo riesgo.
Conclusiones: La implementación de estos espacios es sostenible para los servicios de salud puesto que con una inversión manima se reduce el Ãndice de cesÃ¡reas y mejora los resultados materno perinatales.
English: Background: The LPR rooms allow low-risk women to perform labor, birth and recovery in a safe, respectful and intercultural manner.
Objective: To demonstrate the benefits of the implementation of LPR rooms in hospital health units.
Results: The rooms without technology filled with homelike items such as; wooden beds, wooden arches where rebozos hung, childbirth benches, pleased 100% of users, allows privacy, the evolution of the physiological birth and better compliance with the 56 WHO / PAHO recommendations for respectful low-risk births.
Conclusions: The implementation of these spaces is sustainable for health services since with a minimum of investment, the rate of caesarean sections is reduced and the maternal perinatal results are improved.
04. Global Quality Maternal Newborn Care: Engaging the world in the midwifery model of care.
Facilitator(s): Jane Houston
Description: In order to maximize engagement in “The Year of the Nurse and the Midwife”, Yale School of Nursing designed a new collaborative online course: Global Quality Maternal and Newborn Care. The aim is to disseminate the midwifery model of care and the evidence supporting its implementation in order to reduce maternal and newborn morbidity and mortality. The curriculum is built around the Quality Maternal and Newborn Care Framework developed initially in the 2014 Lancet Series on Midwifery. Designed for policy makers, administrators, clinicians, consumers, and activists around the world, the course includes practical advocacy and action plans to achieve health care quality and outcomes globally in the care of mothers and babies. It includes advice and perspectives from experts in the field, along with current research and high-quality care maternal and newborn care. It is accessible through the Coursera learning platform and offers learners both certificate and non-certificate options.
04. Social determinants of late presentation of cervical cancer
Speaker: Nancy Geregl
Facilitator: Cecilia Jevitt
I am an international student in Australia.
My presentation is about a reproductive health issue for women in Papua New Guinea. We have high incidence of cervical cancer in every health facilities. The mother come during the late stage of cervical cancer. My study seeks to find out the factors preventing women from seeking medical help earlier. Then by analyzing my data I will find solutions to help mothers to get necessary cervical cancer screening and treatment early.
05. Avances de la atencion en salud sexual y reproductiva, que se brinda a la diversidad sexual en el Peru – Spanish
Speaker: Denise Sacsa
Desde El Cairo, el rumbo de la salud sexual y reproductiva se ha ampliado, además de contemplar las tres dimensiones de la salud, abarca todo el ciclo de vida, incluye el derecho de todas/os a adoptar decisiones en relación a su sexualidad y fecundidad sin sufrir discriminación, coacciones, ni violencia. Los Estados tienen la obligación de asegurar las mejores condiciones de atención sanitaria, independientemente de la orientación sexual e identidad de género, de las/los usuarias/os. La pregunta es, los proveedores de salud, ¿hemos desarrollado competencias para cumplir con las exigencias que demandan las/os usuarias/os en la actualidad?, ¿los servicios que se ofertan, son con enfoque de género y respetando la diversidad, identidad y orientación sexual de las/los usurias/os? ¿Qué está sucediendo en el Perú, al respecto?
English: Since Cairo, the path of sexual and reproductive health has expanded, in addition to contemplating the three dimensions of health, covering the entire life cycle, including the right of all to make decisions regarding their sexuality and fertility without suffering discrimination, coercion, or violence. States have the obligation to ensure the best health care conditions, regardless of the sexual orientation and gender identity, of the users. The question is, Do health care providers have developed competencies to meet the demands? Are the services offered, gender focused and respectful of sexual diversity, identity and orientation? What is happening in Peru, in this regard?
05. Labor Pain – It’s all in your Head
Speaker: Tracy Donegan
Facilitator: Jane Houston
There is a current trend toward natural pain management in labor such as yoga, mind-body therapies, water immersion etc however there is limited but growing evidence for many of the complimentary (CAM) therapies. In this presentation I will discuss the need for childbirth education to evolve with the science of pain education. The neuromatrix theory of pain proposes that pain is a multidimensional experience influenced by physical, cognitive and emotional events. Data suggests that when learners (parents) have basic ‘pain literacy’ through an educational intervention midwives can empower parents to intentionally ‘hack’ pain processing networks of the brain in labour to reduce the need for analgesics in labour. For mothers with a strong desire for normal physiological birth it is essential that midwives have an understanding of the neuroscience of pain that can easily be conveyed by midwives and understood by parents in birth preparation classes.
06. Keeping your passion alive – Invited Speaker
Speaker: Hazel Keedle
Facilitator: Red Miller
In this presentation midwife and academic Hazel Keedle offers 10 steps for student midwives to keep their passion for midwifery alive during their training and into their midwifery career. The steps cover both practical and important areas that will keep students, and midwives, connected and inspired during their important yet challenging career as a midwife.
06. Midwifery and Entrepreneurship
Speaker: Priyanka Idicula
Facilitator: Sangheetha Parthasarathy
Birthvillages the natural birthing centre is a free standing birth centre based in Cochin, India. It is one of the oldest birth centres today in India with over a decade of experience , we plan to show case how we started out in a country where independent midwifery does not exist. We aim to showcase our statistics – natural birth rate of 96.4 percent and our transfer rate for epidural which currently stands at zero .We will also explain our challenges and what we envision our future for midwifery and for the women in our country.
07. After Action Review: A Strategy for Teaching Midwifery Theory behind Clinical Actions
Speaker(s): Vicki Penwell
Facilitator(s): Red Miller
Description: It is important to train midwives in an environment of trust and security, which includes honest discussions after each birth about What went right and why and What went wrong, and how can we do better next time? Theory and practice must be linked successfully during the clinical portion of midwifery training if we hope to graduate midwives who are empowered with the ability to be life-long learners and critical thinkers. In our experience of more than 15,500 births over 40 years, all involving student midwives, Mercy In Action believes this goal is best accomplished by the practice of using “After Action Reviews”. After Action Reviews help us determine our strengths and weaknesses as a maternity care provider team, and always link performance to subsequent training. The goal in all of it is seeking to improve care for the midwifery client and improve learning for the student midwife.
08. KEYNOTE :: Autonomous Midwife-led Continuity Of Care: Evidence-based, Respectful Care Within A Collaborative Model
Speaker: Vijaya Krishnan
Facilitator: Linda Wylie
KEYNOTE: Research over the past few years has focused not only on maternal and infant mortality, but also the quality of the care provided, and respectful maternity care as a human right. Research also tells us that antenatal childbirth preparation, which includes childbirth classes and one-on-one counselling has positive effects on the course of labor and delivery, as well as higher rates of breastfeeding. Studies on outcomes of mothers receiving continuous labor support, tell us that she has a higher chance of vaginal birth, less interventions, less C-sections, better start to breastfeeding, less postpartum depression, and an overall better maternal experience. The WHO currently highly recommends Midwife-Led Continuity-of-Care models, in which a known midwife or small group of known midwives supports a woman throughout her antenatal, intrapartum and postnatal period, as a way to improve at least 50 different short-term and long-term outcomes, as well as provide respectful, safe and satisfying maternity care.
This presentation describes the current state of maternity care in India, with nearly 85-90% C-section rates, and lack of respectful, evidence-based care being the norm. India is also a country where there are both extremes of care “Too little, too late”, and “Too much, too soon”. In such an environment, this presentation aims to tie in the benefits of excellent Autonomous Midwife-Led Continuity of Care, within a Collaborative Model of Care (CMC), with in-house Emergency Infrastructure and Consultants. This is a model which we have honed to near perfection over the last 12 years. Our statistics serve as a proof of the efficacy of this Model of Care – 92% Natural Birth rate, 90% VBAC rate, 100% VBA2C, Twin Natural Births and many Breech Births – and, these numbers are inclusive of mothers with complex needs like GDM, PIH, etc.
It will describe how this CMC can be replicated, and how any facility with specifically trained, professional and specialist Midwives, can create a Birth Environment similar to The Sanctum Natural Birth Center.
09. A study to assess the practises adopted regarding respectful maternity care (RMC) by health professionals in labor rooms of selected hospitals of New Delhi
Speaker(s): Manju Chhugani
Facilitator(s): Karen Wilmot
Respectful maternity care (RMC) is a universal human right that is due to every childbearing woman in every health system around the world. Women’s experiences with maternity caregivers can empower and comfort them, or inflict lasting damage and emotional trauma. Method: A descriptive cross sectional survey was conducted in three selected health facilities of New Delhi. Data was collected from sixty three health professionals working in labor rooms to assess the practices adopted by them regarding RMC using self developed observational checklist which was based on the EMC charter. Result: Ranking of RMC performance standards domains were done based on mean score. Standard VI- Left without care was ranked I, Standard II – right to information and preferred choice was not considered was ranked II, Standard VII-Detained or confined against was ranked III, Standard III- Confidentiality and Privacy was ranked IV, Standard I- Physical harm was ranked V, Standard IV – Dignity and Respect was ranked VI and Standard V- Provision of Equitable Care was ranked VII. Conclusion: Facilities based respectful maternity care for all women in labor should be encouraged irrespective of their socioeconomic status. Failure to adopt patient centered approach and lack of health system resources have been identified as major contributing factor for disrespect during labor.
09. Home-birth and midwife interaction
Speaker(s): Abigail Beach
Facilitator(s): Catherine Shimechero
I will be talking about my own 5 home-birth experiences which include 4 after caesarian and how midwife interaction differed at each birth and the corollary effect to each of my labours births and after care of me and my baby and family . I will share personal stories.
10. Teaching evidence based exercise and fitness classes in India
Speaker(s): Donna Mitchell
In India women are heavily censored to take rest and not to move a lot during their pregnancy. They are told not to take stairs, go for walks, travel and even sometimes stop working. This creates a lack of stamina and communication with the body during labor. I created a workout class based on ACOG recommendations on pregnant women being active in a medium to high level intensity. This increases blood flow to placenta and baby, healthier eating and water intake, increased stamina during labor and quicker healing postpartum. How active women are during pregnancy relates directly to healthy pregnancies and satisfaction of their births.
11. Raising Awareness of Autism in Midwifery Practice and Healthcare Settings.
Speaker(s): Diane Bains
Facilitator(s): Halima Musa Abdul
Topics covered will include:
Presentation for Autism in girls (Aspergers and Pathological Demand Avoidance). Exploring the Autism journey from birth, childhood, school and adulthood. The journey of diagnosis in current UK healthcare settings. Lack of Autism Assessment access and provision in NHS under current funding constraints. Misdiagnosis and manifestation of subsequent Mental Health Issues in girls and women. The impact this lack of support can have on relationship and family planning choices. Discussion of the use of ‘masking techniques’ by girls and women as a coping strategy. How to recognise this as a healthcare professional. Techniques used to help support women and advocate for their needs throughout the journey of childbirth. Taking responsibility to raise awareness of Autism in the workplace and community.
12. Birth and social media: how images shape birthing choices into the next decade
Facilitator(s): Carol Maringa
Description: Images of labouring women and childbirth have long been censored on social media, having previously been grouped in a category that Instagram and owners, Facebook, deemed ‘too offensive for the public eye’. However, after an online petition in 2018, Instagram proceeded to change its censorship rules, allowing previously banned images to be freely shared across the screens of our digital devices.
Drawing on the opinions of birth professionals, this cafe style discussion will explore a set of pre-selected images that will undoubtedly inspire, challenge and change the way birth is viewed in all its forms. Following a short presentation, participants will be encouraged to collectively reflect on how, as midwives and consumers entering the next decade, such images will influence and change our understanding of birthing choices.
12. Hands on technique to promote coping in birth
Speaker(s): Heidi Meyer Vallentin
Facilitator(s): Karen Wilmot
Description: I am a midwife and the developer of a technique called the Meyer-method, which is a hands on technique based on Gate control and hypnosis practiced by the midwife to promote coping in birth and redirecting pain signals.
Creating better progression and less pain experience. Thus resulting in less medication and intervention in birth.
Also the technique can be taught to the birthing partner which promotes teamwork and shared better birth experience.
The technique is well known in Denmark and I will present The Meyer method in ICM Bali 2020. Also initiatives towards testing the method has been taken in Denmark. I would love to give this simple technique to midwives all over the world via your conference.
13. Culturally responsive care: The Cross Cultural Workers in Maternity and Child and Family Health model of care for women and families from migrant and refugee backgrounds
Speaker(s): Helen Rogers
Facilitator(s): Susan Kiamba
The importance of ensuring maternity services meet the specific needs of migrant and refugee backgrounds is recognised internationally as a public health priority. The Cross-Cultural Workers (CCWs) in Maternity and Child and Family Health Services was implemented in South Eastern Sydney to enhance and respond to the needs of this population. The CCWs work in partnership with health professionals to support women to access and maintain engagement with health services. This research explores the effectiveness of the Service from the perspective of service providers, service users, and their perinatal outcomes.
Findings highlight a high degree of maternal satisfaction; 97% very satisfied/ satisfied. Women (n=57) reported a positive impact on their experience (84%), increased understanding of pregnancy, birth and parenting (100%), and would recommend to friends/family (100%). Sixty-nine surveys and nineteen interviews with Service Providers show 83% felt the service improved women’s maternity care ‘a great deal’.
13. Perinatal mental health: experiences of mothers during pregnancy and the midwives who support them
Speaker(s): Nicola Savory
Facilitator(s): Ally Anderson
Description: Existing research on poor perinatal mental health largely focuses on recognition and treatment of postnatal depression. Consequently, there is a need to explore antenatal mental health. Interviews with women in late pregnancy aimed to understand experiences of women with mental health problems and focus groups with midwives conducted to explore midwives understanding of their role in providing support.
Thematic analysis of interviews with women (n=20) identified themes: mental health over time, their expectations and control; and knowledge of mental health. Themes identified from the focus groups with midwives (n=15) were: conversations with women around mental health, its complexity and the gap in support. Continuity and more time at appointments were suggested by midwives and women to improve discussions regarding mental health. Midwives were keen to support women but lacked knowledge and confidence. Consistent reference was made to the need for training regarding the practical aspects of supporting women’s mental health.
14. The Acceptability of Routine Screening for Intimate Partner Violence by Pregnant Women in Northern Nigeria
Speaker(s): Ayishetu Musa-Maliki
Facilitator(s): Olajumoke Ojeleye
Routine screening, is the application of standardized questions to all symptom-free women according to a procedure that does not vary from place to place. The purpose of this study is to determine the prevalence of IPV and acceptability of routine screening of IPV by pregnant women in northern Nigeria. A cross sectional descriptive design was used to administered questionnaire to 90 respondents after being screened for IPV with the Abuse Assessment Screen tool. The prevalence rate is 32%, and 80% of Pregnant women were satisfied with, and accepted that routine screening for IPV be incorporated into the ANC daily routine. Their reasons included; it helps them to voice out, receives good advice to their marital problems, and the lives of their foetus can be safe. There is pressing need for policy makers, at all relevant levels, to make policies on routine screening for IPV to be included in ANC routine.
15. Fisología del Parto Basada en la Evidencia (Spanish)
Speaker: Raquel Justiniano
Facilitator: Marcela Mendoza
Si bien sabemos que es importante comprender como las intervenciones obstétricas pueden reducir los efectos patológicos del parto, aprenderíamos mucho más al comprender la fisiología del trabajo de parto y parto y como podemos favorecer su desenvolvimiento. En nuestro contexto global y también latinoamericano, se estudian e investigan nuevos enfoques sobre las patologías del embarazo y el parto, llevando a nuevos diagnósticos e intervenciones obstétricas para salvar la vida del binomio en riesgo. Sin embargo, dejamos poco espacio para investigaciones que se enfoquen en el estudio propio de la fisiología del embarazo y nacimiento. A pesar de que el trabajo de parto y parto son los aspectos más regulados y controlados en la vida de las mujeres, muchos juicios y decisiones importantes se toman en un contexto de incertidumbre, con información imperfecta, y resultados preocupantes. En esta sesión analizaremos recientes investigaciones sobre la fisiología del parto y como estas están desafiando muchas creencias firmemente arraigadas en la práctica cotidiana de muchos profesionales que asisten embarazos y nacimientos.
English: Scientific evidence on normal birth
The language barrier is a key factor why midwives and student midwives in Latin American countries can not access (or it may take years before there is a translated source) to latest research on midwifery/ mother-infant health. My intention is to share and provide research evidence on normal birth. Share published articles translated into Spanish. And reference the book “Squaring the circle” for various topics about normal birth, women´s experience during childbirth, and the long term impact on the mother and infant health.
I want to encourage and challenge student midwives to look into new research, learn and share evidence based practices to promote change in our birth culture and educational institutions.
15. Making discoveries through research: midwifery student’s perceptions of their role when caring for pregnant women who misuse substances: neonatal simulators as creative pedagogy
Facilitator(s): Carol Maringa
Background: There is minimal research involving undergraduate midwifery students interacting with neonatal simulators as creative pedagogy.
Objectives: Midwifery students to interact with Foetal Alcohol and Drug Affected neonate simulators as a means of co-constructing knowledge around the effects of substance misuse during pregnancy and postnatally.
Study setting and participants: Level 4 student midwives from a UK University in the South West of England.
Methods: A taught session on protecting the unborn environment; interaction with the neonatal simulators; planned activities
Results: Three broad themes: Kinaesthetic Learning, In Their Shoes and Midwifery Role in Educating Others.
Conclusions: Students as researchers emphasised the importance of interacting with the simulators as creative pedagogy as a method for enhancing their knowledge and as a means of building new knowledge. This research has helped bridge the disconnect between teaching, research and practice as students were able to reflect on their future roles as midwives.
16. Evaluation of the new Bangladesh Young Midwife Leadership Programme
Facilitator(s): Jennifer Akuamoah-Boateng
Effective midwifery leadership has been identified as a key component for improving the midwifery profession at the strategic level. The Bangladesh Midwifery Society in partnership with the Royal College of Midwives have developed a bespoke Young Midwife Leader (YML) Programme for Bangladeshi midwives. With midwifery only being introduced in Bangladesh in 2014, ensuring midwives have a seat at the decision-making table in Bangladesh is integral for embedding the profession in the country’s healthcare agenda.
The YML Programme delivered a range of training to participants aiming to equip them with important midwifery leadership skills. These included training on project management, IT, advocacy, media, and training in research and writing abstracts. In our presentation you will hear from some members of the first cohort of YML to graduate from the programme. Alongside sharing their experiences, we will reflect on the successes and challenges of the programme so far.
16. Virtual and Real Time Sharing and Comparing Midwifery Practices Among US and UK Midwifery Students
Speakers: Midwifery students from Georgetown University and Oxford Brookes University; Faculty members Cindy Farley and Ethel Burns.
Facilitator: Lorraine Mockford
Midwifery students from Georgetown University, US, and Oxford Brookes University, UK, were connected by e-mail prior to a Short Term Study Abroad to explore midwifery in the UK by US students. Called “Inter-Pals”, short for International Internet Pen Pals, this introduction via e-mail began conversations and relationships that set the stage for a successful in-person exchange. Once US students were welcomed at Oxford Brookes University, the Interpals were placed together with other midwifery students in small groups and given time to share US and UK midwifery practices. Each small group then summarized their comparisons to the whole class. Reflections were collected; overall feedback from both US and UK students was extremely positive. This presentation will describe the virtual and real time sharing structured jointly by the US and UK faculty and the learning from this experience by several Interpal US and UK participants.
17. Effectiveness of a Planned Home Birth education on midwives attitude towards PHB practice: A randomised controlled Trial
Speaker(s): Auwala Muhammed
Facilitator(s): Elisa Segoni
In Nigeria, there is a need for a positive attitude towards choice of birthplace. This study evaluates the effect of a planned home birth (PHB) education on midwives’ attitude towards PHB. We recruited and randomly allocated 226 midwives into intervention and control. The intervention group received training, while the control group maintained a usual care. Data were collected three times using a questionnaire and analysed using linear mixed models. The findings revealed a significant change in the attitude within the intervention group (F = 75.77, p;0.001), but not in the control group (F = 0.83, p =0.438). Midwives in the intervention were more favourable towards PHB compared to the control group at the immediate post-intervention (p;0.001, d = 0.9), and three-month follow-up (p;0.001, d =0.8). PHB education promotes a positive attitude towards PHB among midwives. The finding may be an initiative towards safe motherhood and midwifery model.
17. Evidence Based Care during the COVID-19 Pandemic :: Invited Speaker
Speaker: Rebecca Dekker
Facilitator: Karen Wilmot
During these uncertain times, it can be helpful to focus on facts and evidence-based information! In this session, Dr. Rebecca Dekker will talk about the latest research evidence on COVID-19 and pregnancy, as well as the implications of this research for families who are due to give birth during the pandemic. By the end of this session, you will be able to discuss the available research on COVID-19 in pregnancy, guidelines from professional groups from around the world, and the human rights of laboring families during a pandemic.
Founder, Evidence Based Birth®
18. KEYNOTE :: The Midwifery Mandate in Global Crises: Leadership, Innovation, and Humility
Speaker: Saraswathi Vedam
Facilitator: Cecilia Jevitt
The World Health Organization (WHO) and Office of High Commissioner of Human Rights have affirmed that freedom from discrimination, harm and mistreatment are human rights and important outcomes (Bohren et al., 2015), and[i] that health systems need to improve measurement and accountability for the experience of childbearing care (Freedman and Kruk). Loss of autonomy, mistreatment, abuse, coercion, and disrespect during pregnancy and facility-based birth before and during the COVID-19 pandemic have been documented by researchers, clinicians, lawyers, governments, and community organizations. Poor treatment due to institutional racism, implicit bias, and lack of access to preferred models of care, can transform health care encounters into human rights violations. Among families with non-dominant identities, circumstances, or backgrounds, asymmetric and hierarchical power relationships, as well as gender-based violence, these health inequities are exacerbated.
Integration of midwives into health care systems is a key strategy that can improve quality of care (Lancet 2014). Overall, in high, middle, and low resource settings, those who experienced midwifery care report lower interventions, more respect, and greater autonomy in decision making; but experiences of discrimination and disrespect are still significantly increased among marginalized communities, regardless of type of provider or birth setting. Indigenous midwifery traditions, and strengths-based community-led rapid response to adverse environments can offer innovative solutions to all midwives.
What is our responsibility as midwives to model self-reflection, leadership, adaptability, collaboration, and accountability for improving equity, access, and respect during reproductive health encounters? This session will describe emerging research findings on the prevalence and characteristics of respectful maternity care, midwifery strategic leadership, and transdisciplinary initiatives to address the gaps in respectful care for all families – during global crises and beyond.
19. Childbirth: A Traumatic Experience?
Speaker: Paula Miller
Facilitator: Cynthia Pitter
Childbirth is a celebrated and positive stage in a women’s life cycle. For some women, the experience of childbirth is not quite so positive and can adversely affect psychological health and wellbeing. This presentation will focus on what constitutes as a traumatic birth, the psychological effects of a traumatic birthing experience on mother and infant and ways of reducing these effects. Current evidence base on interventions to alleviate psychological stress and co morbid symptoms following traumatic birth will be presented, along with barriers to intervention implementation such as midwifery job task demands and access to specialised training/supervision in perinatal mental health.
Presenter: Paula Taylor Miller, MSc. Occ Psy. awarded PhD scholarship, Centre for Maternal, Fetal and Infant Research, Ulster University, funded by The Department for the Economy, Northern Ireland. Supported by supervisors Professor Marlene Sinclair, Dr Patricia. Gillen, Dr Julie McCullough, Professor Paul William Miller.
20. How leadership, management skills can be developed to improve midwifery?
Speaker(s): Lourdes De La Peza
Facilitator(s): Elisa Segoni
Training midwives in leadership, management, and governance (L+M+G) has been identified as a key intervention by the Lancet and the World Health Organization to ensure effective provision of maternal, newborn, and child health (MNCH) services worldwide. UNFPA (State of the World’s Midwifery, UNFPA, 2014) recommends the employment of 112,000 midwives in 38 developing countries and questions curriculum that teach only clinical skills. Studies conducted by Australian College of Nursing (ACN) have also established that strong Nursing and Midwifery leadership leads to better workplace environments, better staff retention, and patient health outcomes in general. During this presentation it will be discussed the potential of the Leadership, Management and Governance for Midwifery Managers certificate (Developed by the USAID-funded LMG Project) to provide midwifery managers with L+M+G skills to address challenges and improve MNCH outcomes.
20. Political Will and Student Midwives in The Year of the Midwife – Invited Speakers
Facilitator: Tanya Belcheff
Midwives can make a difference in the health policy arena for women’s health by advocating for social justice and the common good. Political participation is addressed but not a focus in basic midwifery education as students and faculty are prioritizing the acquisition and application of foundational midwifery knowledge and skills to become safe beginning clinicians. However, once new graduates step out into practice, they begin to realize the importance of legislation and regulation on the ability to practice to the full extent of their training and expertise. Student midwives need to have foundational skills in political advocacy in addition to beginning skills in midwifery care in order to make significant positive change.
The governing body of the World Health Organization let the political will of 194 nations be known in declaring 2020 the Year of the Midwife. It is a wonderful opportunity for those involved in care of childbearing women to organize small groups of practicing professionals and students to speak to legislators and regulators on ways to address the critical issues of our time. This presentation will discuss ways to use this momentum to press for laws and policies that are equitable to all people, provide respectful maternity care as a human right, and assure all women everywhere access to a midwife.
21. Making a difference: Community Health Workers in Sierra Leone
Speaker: Patricia Ross
Facilitator: Niessa Meier
Teaching illiterate farmers in rural Sierra Leone to act as maternity care providers and change agents seems daunting. MOMS (Midwives on Missions of Service) has done this successfully since 2007. We created and refine a multi-pronged model, based on respectful partnerships, to build capacity. This model works well, especially by including local leaders, as we build a sustainable organization across the country. Areas where MOMS Community Health Workers work And even just live have significantly improved outcomes. These 500 women, with more graduates coming, have made an enduring difference. We will describe our model, the ugly lessons we learned, and what makes us so successful. We will cheerfully answer questions about applying our model to other settings.
21. Student Midwives’ Views and Experiences of Birth on Mainstream Factual Television
Speaker: Hannah Slack and Beatrice Bennett
Facilitator: Jennifer Akuamoah-Boeteng
Childbirth is a popular topic for mainstream factual television. Reality TV shows, like One Born Every Minute and Delivering Babies, attract large audiences but it was unclear how that might influence students’ decisions to study midwifery.
The objectives were to investigate student midwives’ experiences of viewing childbirth on mainstream factual television and to explore implications for career intentions and potential pedagogical uses of television excerpts in midwifery education.
Following four focus groups and thematic analysis, four main themes were agreed upon:
- a) Changed Perspectives on Televised Childbirth
- b) Representations of Midwives and Social Implications
- c) Representation of Childbirth and Social Implications
- d) The Role of Televising Childbirth in Midwifery Education
We will discuss the research that was undertaken, the findings with explanations and the conclusions that have followed on from this, including future recommendations.
22. Barreras en la atención centrada en la mujer gestante en la Unidad de ParterÃa en Chilpancingo Guerrero; México (Spanish)
Speaker: Merilin Villagomez Chico
Fondo: La unidad de Partería Alameda es un espacio para la atención de la mujer de bajo riesgo de manera segura respetuosa e intercultural.
Objetivo: Mostrar las barreras que no permiten la atención centrada de las usuarias que acuden a la unidad de partería Alameda.
Metodología: Estudio retrospectivo, descriptivo y observacional de mujeres en el servicio de pre consulta Población: 350 usuarias de julio a diciembre de 2019, muestra de 132 mujeres entrevistadas durante la consulta.
Resultados: Más del 80% de las mujeres están acostumbradas a una atención medicalizadas y rutinaria, 30% consideran un problema el acompañamiento durante la consulta y prefieren acudir solas, las mujeres solteras embarazadas presentan menor apertura al modelo de atención.
Conclusiones: La cultura de la atención centrada aun es un reto, es necesario continuar la difusión, atención y cuidado a las mujeres para generar una cultura del autocuidado en la mujer y su familia.
English. Background: The Alameda Midwifery unit is a place to care for low-risk women in a safe, respectful and intercultural way.
Objective: To show the barriers that do not allow women-centered care for users who go to the Alameda midwifery unit.
Methodology: Retrospective, descriptive and observational study of women in the pre-consultation service
Population: 350 users from July to December 2019, sample of 132 women interviewed during the consultation.
Results: More than 80% of women are accustomed to a medicalized and routine care, 30% consider having a support person as negativa and prefer to assist alone, pregnant single women have less openness to the model of care .
Conclusions: The women centered care perspective is still a challenge, it is necessary to continue the dissemination of this model of care, and to raise awareness of self-care in women and their families.
22. Transformation of the Uterus and the Dance of Labour
Speaker: Margaret Jowitt
Presents a new biomechanical model of uterine function, explaining the mechanism of uterine activity in terms of the mechanical properties of uterine tissue. Once the power is unleashed, the fetus sets the pace. Tells how the movements of mother and baby work with – or against – the uterus to position the baby optimally for the journey through the pelvis. How midwives can enable mothers to work with their baby and their uterus to achieve better birth.
23. Even some of us were being slapped, and then what do you do, is just at the expense of your job: Midwives’ experiences and prevention of workplace violence in Tertiary Hospitals Northern Nigeria
Speaker: Halima Musa Abdul
Midwives have been reported as experiencing higher levels of stress compared to other healthcare professionals. In Nigeria, midwives’ stress is further increased due to palpable shortage of midwifery workforce and heavy workloads. This study explored midwives’ experiences of workplace adversity and resilience in tertiary hospitals in Northern Nigeria.
This study used a constructionist-grounded theory approach. Following ethical approval, data were collected via interviews and field notes with purposive and theoretical samples of midwives (n =34) across two tertiary institutions in Northern Nigeria. Data analysis was through the constant comparison process of grounded theory.
An unexpected finding was that adversity in the workplace could be caused by aggressive behaviour from women and their relatives resulting in a difficult midwife – client relationship.
Workplace violence within maternity is due to aggressive behaviour from women and their relatives among other factors. Understanding the resilient strategies adopted by these midwives is key to prevention.
23. Gestión Natural de la Fertilidad: Método sintotérmico (Spanish)
24. KEYNOTE :: Ecology of childbirth
Speaker: Susan Crowther
Facilitator: Annette Dalsgaard
In this presentation Susan will journey through her work and insights about psycho-spiritual wholeness in and around childbirth revealing how childbirth is a significant and seminal human encounter with life. These moments in our lives are precious and need to be treated with care and tenderness lest we loss something of existential value. Much work still needs to be done in our health systems for them to align fully with the fullness of what childbirth is beyond the biomedical understandings that predominantly inform our current systems of care. Susan will share recent outcomes of an international co-operative inquiry that explored ways of transformation in how and what we do to enhance and honour an ecology of childbirth.