As an alternative to presenting at the Virtual International Day of the Midwife conference we received a number of posters. These are available online during the conference and throughout the month of May.  Later check the Conference Archives to review these for the foreseeable future. Many of the poster presenters opted to be interviewed about their posters. Click on the podcast recordings found under their names to hear what the presenters have to say about their research. Click on a poster image for a larger view.

VIDM 2021 Poster Presentations

Presenter informationAbstractPoster / Title
Bethany Leahy , Stage 4 BSc Midwifery, University College Dublin, IrelandChild Sexual Abuse (CSA) is defined as any sexual contact or exposure in childhood by another person for their own gratification. Prevalence estimates are 20% among females, with long term effects including upon pregnancy and birth. Research was based upon 10 articles; six quantitative studies, two qualitative and two mixed method. Data collection methods varied from interviews, to hospital records and statistical analysis. Women with a history of CSA are more likely to experience preterm birth and report symptoms like headaches, nausea and dizziness. There is no screening for CSA. The topic elicits feelings of shame, leading to a lack of disclosure. Birth tends to be perceived by survivors as frightening, with exposed situations such as vaginal examinations inducing flashbacks. Perceptions of motherhood are twice as likely to be negative. Midwives are in a position to initiate disclosure and screen women. Individualised care and continuity is particularly important in survivors.Effects of childhood sexual abuse on pregnancy and birth
Bethany Leahy poster
Niken Bayu Argaheni, Universitas Sebelas Maret, Indonesia

Background: The COVID-19 pandemic threatens such as pregnant women who are predicted to be at higher risk and more susceptible to exposure. The purpose of this study was to find out the knowledge about COVID-19 among pregnant women and how their motivation to continue pregnancy.
Methods: Researchers collaborated with SEKOCI (Sekolah Komplementer Cinta Ibu) to provide bold counseling to its members consisting of 69 pregnant women from various cities once every 7 days for 1 month, then an online questionnaire was evaluated the knowledge, the feelings and motivation for pregnancy during the COVID-19 pandemic.
Results: This study shows that respondents who have good knowledge about COVID-19 (76%), experience moderate levels (69%), and have motivation to do pregnancy (93%).
Conclusion: Pregnant women in Indonesia have good knowledge about COVID-19, and still have the motivation to come to health workers.
Pregnant women during the COVID-19 pandemic in Indonesia: Knowledge, anxiety and motivation
Argahen poster
Nikoleta Chatzipanagiotidou, Midwifery Department, University of Western Macedonia, Greece

Lupus is a chronic systemic autoimmune disease that occurs when the body's immune system attacks its own tissues and organs because it cannot tell the difference between viruses, bacteria, and other germs and the body’s healthy cells, tissues, or organs. Out of 1.5 million Americans with Lupus, 90% are women between the ages 15-44. Lupus affects them greatly when it comes to making the decision of getting pregnant. There are a lot of misconceptions that Lupus prevents people from getting pregnant and there is not enough information given to those who are interested and the results of that are showing very clearly on the studies that have been done. This poster aims to provide accessible, evidence-based knowledge on the subject of pregnancy with Lupus in order to inform people about the possibilities that women with Lupus have on the matter of becoming pregnant.Lupus and pregnancy
Chatzipanagiotidou poster
Isabella Garti, AustraliaPre-eclampsia (PE) management in low- and middle-income countries (LMIC’s) is less optimal as prevailing health disparities interfere with its management. Overwhelming evidence shows that within their defined scope of practice, regardless of birth setting, midwives are pivotal in the management of both normal and abnormal chain of events in pregnancy including pre-eclampsia. The absence of clear policies and huge variations between international recommendations and national protocols impede evidenced based practice as they present missed opportunities for timely interventions to be initiated and may reduce the impact of midwives in pre-eclampsia management. Therefore, an examination of existing policies influencing pre-eclampsia management by midwives in a LMIC is a key cornerstone necessary to unearth local insights and identify key strategies based on evidence that can improve the quality of care and yield better maternal and fetal outcomes.A qualitative review of policies influencing pre-eclampsia management by midwives in Ghana: What are the gaps and opportunities?
Rhiannon Grindle, Midwives at Maternity Azur (MAMA)Despite 50% improvement since 1990, Uganda's maternal mortality ratio is estimated at 375. Multiple contributory factors exist, grouped into three overarching delays: health-seeking behaviours; care accessibility; and care quality. After three years running outreach antenatal clinics in Kyarushesha village, we opened a midwifery-led clinic in March 2020, funded by UKAid Direct, providing round-the-clock childbirth care, alongside daily antenatal clinics and regular family planning and childhood immunisations. In the first eleven months, 3448 patients attended antenatal appointments (monthly mean 313, standard deviation (SD) 43) and 319 babies have been born (monthly mean 29, SD 9). There have been no maternal deaths, and four stillbirths (rate 1.3%, compared to 3.7% reported by the local regional referral hospital). Our clinic reduces the distance women have to travel to a health facility, enhancing access to skilled medical staff, medical resources and comprehensive referral services, thereby increasing skilled birth attendance and decreasing serious pregnancy complications.
Birth Equity For All
Grindle poster
Rafaela Joos, Germany
Signs of a healthy birth. Observation of the healthy birth process by midwives. Background: «Unique normality», that each person’s uniqueness is normal for them, has been recently postulated in the literature as a new paradigm in midwifery practice. Midwifery skills should include a holistic, woman-centered care during a healthy birth. Instead of a linear approach where, birth should be considered as a circular process. Method: Within the setting of action research, four semi-structured interviews with midwives with expertise in the field of birth centre or homebirth were conducted and an observation chart for the healthy birth was developed. The qualitative interview analysis was carried out with the Mayring method. Results: The multi-faceted knowledge of midwives is demonstrated. A comprehensive observation chart for the observation of a healthy birth could be provided. Conclusions: Each birth is unique and requires continuous individual observation by the supervising midwife.Signs of a healthy birth / Zeichenlehre der gesunden Geburt
Joos English Poster
Joos German poster
Shujana Keraudren, Christine McCourt, and Lucia Rocca-Ihenacho, City University of London, England.A review of the literature has emphasised the lack of information provided to pregnant women to make an informed decision on their method of delivery. Effective strategies creating awareness on CS are yet to be validated, despite the emergence of research acknowledging the importance of communicating its risks and benefits to pregnant women in an unbiased manner. This has led to questions around the extent of women’s awareness of the consequences of a caesarean section (CS). Previous cross-sectional studies have varied in whether they have found an association between women’s level of knowledge on CS and the increasing rate of caesarean. The aim of the present study is to evaluate women’s knowledge of the evidence surrounding the risks and benefits of CS.Pregnant women's knowledge about caesarean birth
Keraudren poster
Atsede Kidane and Indie McDowell, Association of Independent Midwives, EthiopiaThis poster is the launch of a new organisation, the Association of Independent Midwives, Ethiopia, which aims to empower, support, and advocate for midwives working in non-governmental service delivery or education facilities across the country. It looks at the aims and objectives of AIM Ethiopia, as well as some of the projects established in 2021. The ethos of AIM Ethiopia is to elevate the status of independent midwives, and in doing so empower them to provide the best care possible. Empowered midwives empower women.Association of Independent Midwives, Ethiopia
Kidane and McDowell poster
Céline Lemay, Université du Québec à Trois-Rivières, Québec, CanadaIn order to become an autonomous practitioner, the midwife must acquire knowledge, skills and be also be able to exercise clinical reasoning for the exercise of her professional judgement. We know that effective clinical reasoning skills have a positive impact on patient outcomes. Conversely, failure to make a good diagnosis can lead to delays in the establishment of treatment and inappropriate management of complications. The need to understand, to teach and to value clinical reasoning and to practice safety is even more important in healthcare systems where routines and protocols are leading to loss of midwife’s autonomy and also quality practice. We can learn about the clinical reasoning cycle, common bias leading to errors, signs of lack of clinical reasoning, aptitudes to develop and strategies to model clinical reasoning cycle. Midwifery will be empowered and in turn truly empower women. Decision making in clinical settings: The importance of clinical reasoning skills
Celine Lemay poster
Teresa LW and Inderjeet Kaur, Fernandez Foundation, India
The World Health Organization (WHO) recommends Delayed umbilical cord clamping (not earlier than 1 min after birth) for improved maternal and infant health and nutrition outcomes. The aim of this paper is to investigate the effect of delayed vs early cord clamping on breast feeding and skin to skin contact rates. Retrospective data collection of six-month data from 1741 mothers who birthed at Fernandez hospital is analysed from July 2020 to December 2020. The analysis shows that 292(17%) mothers had early cord clamping soon after birth of the baby followed by 1449(83%) had delayed Cord Clamping. The breast feeding and skin-to-skin contact rates were high among the mothers who had delayed cord clamping. We recommend delayed cord clamping for all births irrespective of the mode of delivery unless there is an indication to separate the mother and baby.
Effect of delayed vs early cord clamping on breast feeding and skin to skin contact rates
Teresa LW Poster
Manjula Macharapu and Inderjeet Kaur, Fernandez Foundation, IndiaBackground: The midwives at Fernandez supported women’s choice of water birth ensuring protective measures during the COVID 19 pandemic. Methods: Retrospective data on water birth services offered during COVID-19 Pandemic from April 2020 to Feb 2021 was considered. Results: The total number of water births supported by midwives from April 2020 to Feb 2021 is 28. In the months of April, May and June water births were not offered initially due to COVID restrictions. The team reviewed the evidence and chose to support women with this choice. There were no adverse maternal or neonatal outcomes. The duration of labour for all births is < 4 hrs. The weight of all the new-borns is >2.5 Kg and APGAR scores for 1, 5, 10 minutes were >7. Conclusion: Midwife led care and offering water births as an informed choice empowered women and reduced fear for mothers during this pandemic.
Respecting and supporting women’s choices to choose water births during the COVID-19 pandemic
Macharapu and Kaur poster
Mary Kay Miller, DNP Project, Frontier Nursing University; USABackground: The use of continuous external fetal monitoring (cEFM) contributes to the United States’ high cesarean section (C/S) rate. Florida’s C/S rate exceeds the national average and varies greatly, suggesting that clinical practice patterns, especially cEFM, play a role. The use of intermittent auscultation (IA) of the fetal heart rate safely lowers the C/S rate without negatively impacting birth outcomes. Local Problem: Though 92% of the Tampa General Hospital (TGH) team surveyed agreed that evidence-based practice (EBP) should be utilized, only 29% of IA-eligible low-risk women received IA. The goal was to increase the use of safe and effective IA in low-risk eligible patients at TGH by 50% within 90 days. Methods: An 8-week quality improvement project was implemented using four plan-do-study-act (PDSA) 2-week rapid cycles. Chart audits revealed that 88% (N = 81) of IA-eligible TGH low-risk patients received effective screening and safe use of IA in labor.Promoting safe and effective physiologic birth in a tertiary care center utilizing the ACNM intermittent auscultation bundle
12 Mary Kay Miller poster
Kalavathi Mudili and Inderjeet Kaur, Fernandez Foundation, India
Introduction: At Fernandez Foundation, the Breech clinic was introduced weekly in June 2019 after multidisciplinary breech training by Shawn Walker. Method: Retrospective data collection of 68 low risk mothers with breech presentation between 32-38 weeks attended breech clinic from June 2019 to March 2020. Results: Spinning baby exercises explained at the initial visit. 27 babies (45%) turned cephalic when checked for presentation between 36-37 weeks. 8 notes were misplaced, 33 mothers (55%) offered ECV. 14 (42%) mothers accepted ECV and 7(50%)were successful. Out of 19 (68%) mothers 5(26%) accepted the choice of a Vaginal Breech Birth and 3 (60%) mothers had physiological Breech Birth. There were no maternal or fetal morbidities in Vaginal Breech Births. Conclusion: The breech team and midwifery consultations offered mothers who were eligible, the choice of physiological breech birth. This will also impact on the caesarean section rates for breech presentation. Reviewing evidence and revisiting the option of caesarean sections in breech mothers by offering physiological breech as a choice of birth
Mudili poster
Auwalu Muhammed, Department of Nursing Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto; Lee Khuan; Shariff-Ghazali Sazlina; Salmiah Md Said; and Mairo Hassan, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
This study was to determine the effect of a PHB education in promoting a positive norm towards PHB among midwives. A parallel group randomised controlled trial was conducted among 226 midwives. A close-ended questionnaire was used for data collection. The intervention group received training, while the control group maintained a usual care. Data were re-collected at immediate-post, and three months follow-up. Statistical analysis showed a significant change in the mean subjective norm within the intervention group (p;lt;0.001), but not in the control group (p =0.140). The participants in the intervention demonstrated a more positive norm towards PHB practice compared to the control group at immediate post-intervention (p & lt;0.001, d =0.9), and three-month follow-up (p & lt;0.001, d=0.9). PHB education is effective in promoting a positive norm towards PHB practice among midwives. The finding may inform midwives and policy makers on the strategy to create a network of collaboration towards safe motherhood.
Promoting a positive norm towards planned home birth practice among midwives: A randomised controlled trial
Erika Agung Mulyaningsih, Stikes Pemkab Jombang, Indonesia
UNESCO said 73% of schools were closed for 3 months or more due to the Covid-19 pandemic. Face-to-face learning at Diploma III Midwifery Program has been stopped for more than 9 months. Efforts to achieve competence in Midwifery Education are a problem that must be solved innovatively. The purpose of this study was to improve student motivation and learning outcomes through the Lesson Study method. The method of this research is Classroom Action Research which is conducted in two cycles, The research was conducted on third semester students on contraceptive study materials which consisted of 9 topics. Lesson study can increase student motivation and learning outcomes. Various innovations and creativity are needed for students and lecturers to continue learning and teaching in a pandemic situation which is supported by the management in improving the quality of learning.
Improving midwifery students motivation and learning outcome in contraceptive course
Mulyaningsih poster
Lubica Rybarova, University of Prešov; Stefania Andrascikova; and Zuzana Platko, Slovakia
The aims of the study were to confirm the Slovak version of the Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ-A) of 2005, to find out FOC intensity in a selected sample of pregnant women, and to determine factors influencing levels of fear. We found that the Slovak version of the W-DEQ-A questionnaire is a valid instrument for measuring FOC. Trimester, previous negative birth experience, and instrumental birth or C-section influence the intensity level of FOC during pregnancy. In accordance with our findings, we advise to improve childbirth education, to discuss concerns of women regarding childbirth, and advise psychological help if needed. REFERENCES:
Rybarova et al - REFERENCES.docx
Validization of the revised version of the W-DEQ-A questionnaire in a selected sample of Slovak women
Rybarova poster
Sheetal Samson, India
In Indian health care settings Midwifery-led care is in its infancy. In public maternity settings, practice of prophylactic episiotomy is implemented for all primigravidae and for those with diagnosis of meconium-stained liquor or LGA baby. From December 2020 to January 2021, 55 mothers were supported during birth by the midwifery mentors and trainees of the Telangana State Nurse Practitioner in Midwifery [NPM] program. The group we studied had 24(44%) primigravidae, 52(95%) with term gestation and 3(5%) with MSL. Perineal protective measures like intrapartum mobilization, warm perineal compresses during active second stage, birth positions of choice along with perineal support and helping mothers breathe out their baby slowly were used. Results revealed only 3(5%) mothers needed an episiotomy, 22(40%) had intact perineum post-birth .None had extensive tears. Twenty one (38%) babies had birth weight of 3kgs and greater while 53(96%) enjoyed the first golden hour with skin-to-skin contact.
Impact of intrapartum midwifery-led care on routine episiotomy rates in a public health care setting in South India
Sheetal Samson poster
Barbora Snuggs, University of North Georgia, Vanderbilt University, USA
Many pregnancies and births bring joy and excitement while some end with the death of the baby prior to labor and delivery, also known as an intrauterine fetal demise (IUFD) or a stillbirth. Midwives are closely involved in care for these women during labor and delivery, but evidence-based care guidelines related to midwifery care during the postpartum period following a term stillbirth are limited in the literature published in the United States. A midwifery guideline was developed based on 1) a needs assessment, 2) a literature synthesis, and 3) current guidelines to care for women following a term stillbirth in the initial 6-week postpartum period with input from obstetrician-liaison and the midwives working in a practice setting. Midwives can care for patients utilizing their clinical knowledge with skill, empathy, and compassion by following an established term stillbirth postpartum clinical guideline.Midwifery postpartum clinical guideline following a term stillbirth
18 Barbora Snuggs poster
Loredana Zordan, Independent midwife, Italy
Acupressure is an ancient Chinese technique based on the principle of acupuncture which involves the use of finger pressure (without the needle) on specific points along the body. Chinese culture believes the points to the junction of the meridian pathway that carry energy called QI, Acupressure stimulates the bodies own energies to help fight illness and restore harmony. Acupressure has also been used to stimulate contractions, helping to induce labour. Induction of labour is common as Post maturity can pose risks for the pregnant women and the unborn child, increasing the risk of stillbirth. Acupressure helps to establish contraction and promote cervical dilation. The acupressure points commonly used for induction of labour, have a very strong effect on the energy of the uterus, causing uterine activity and promoting a downward expulsion of the foetus. We have chosen to focus on acupressure rather than acupuncture as acupressure is a less invasive procedure and has the advantage that the woman or her partner can administer it themselves. The case presentation here reports a case of successful use of acupressure for induction and augmentation of labour for post maturity in a home birth situation.Case study: Acupressure for induction and augmentation of labour
Loredana Zordan poster

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