Virtual International Day of the Midwive conference 2021 – Programme
All times are UTC.
Pre-Conference :: World Health Organization: Global progress on midwifery: What does the future hold for birth equity for all? May 4 @ 19:00 – 20:30
Facilitator: Jane Houston
Join the World Health Organization (WHO) Director General, the Chief Nurse (a midwife!), and the Midwifery Advisor to hear the headlines of the State of the Worlds Midwifery Report – hot off the press! Find out what the future holds for midwifery education, services, workforce, and leadership from WHO midwives around the world. This is your opportunity to ask questions and give your valuable inputs to WHO.
With videos from Harriet Chanza (National professional Officer/Family Health and Population at World Health Organization, Malawi Country Office) and Pragati Sharma (WHO Consultant to India’s national Midwifery initiative), discussing their work. Be sure to view the powerful Parallel Lives video from Water Aid shown during this presentation: https://www.youtube.com/watch?v=pz84KiKAKPs
01. KEYNOTE :: Building equity through vocation and profession: Future perfect? May 4 @ 22:00 – 22:50
Keynote Speaker: Soo Downe
Facilitator: Catherine Salam
The growing emphasis on professionalism in midwifery and in other health and social care groups runs the risk of obscuring the critical role of vocation in these occupations. As ‘professionalism’ becomes increasingly identified with power and elitism, and with managerial control and standardization, the question of personalized, equitable, humane health care is becoming increasingly acute. This is a critical area of investigation in midwifery, for all women and childbearing people, and especially for those who are currently most marginalized. This presentation will explore some of the issues arising from the apparent conflicts between ‘professional’ and ‘vocational’ approaches to midwifery and to maternity care, in the light of some of the current issues midwives encounter, from maternal mortality to informed choice. The intention is to raise some questions for debate, and to propose that a synergy of vocational and professional ways of being might help us to create a ‘future perfect’ form of equitable maternity care.
Adapted from an earlier presentation to the RCM Research Conference 2021
02. Dónde queda la “Equidad de Nacimiento para todos” en medio de la pandemia? (Spanish) May 4 @ 23:00 – 23:50
Speaker: Susana Ku
Current pandemic has impacted all systems and has demonstrated the weaknesses of health systems around the world, highlighting the absence of health equity. In response to this phenomena, in June 2020, WHO released a guideline to call countries around the world to ensure continuity of provision of essential care services, including sexual and reproductive health. In addition to this report, different stakeholders called for actions to respect and advocate for sexual and reproductive rights. But what does this mean to Latin-American countries, where basic sexual and reproductive rights are sometimes non-existent? How can midwives advocate for women or birthing person rights in a context where gender violence is so deeply immersed in our society? The speaker will present a rapid grey literature on advocacy for sexual and reproductive rights during pandemic, then it will evolve in a series of reflections on how midwifery profession contributes to this matter.
02. Supporting the Family Ecology: The critical implications of first time fathers massaging their infants after birth May 4 @ 23:00 – 23:50
Speaker: Mary Kay Keller
Facilitator: Leila Kent
New fathers step into the role of fathering with little support from family systems (McBride, 1989; McBride & Lutz, 2004), and transitioning into this role is often stressful (Sanders, Dittman, Keown, Farrauggia & Rose, 2010; Willinger, Diendorfer-Radner, Willnauer, Jorgl, & Hager, 2005). Furthermore, the marital relationship is negatively impacted as parents adjust to their new roles (Johns & Belsky, 2008), and this change may also impact attachment to their infant (Green, Furrer & McAllister, 2007). Infant massage training provides the opportunity, skills, and the feeling of parental competence in interacting with their infants. Cheng, Volk, and Marini (2011) found that fathers greatly benefited from infant massage group classes with other fathers. Infant massage taught either in group or in-home could greatly benefit the family relationships. These outcomes have implications for fathers, professionals, and research. How can professionals be inclusive of fathers?
03. Maternity care for women with a history of sexual abuse May 5 @ 00:00 – 00:50
Speaker: Sarah Smits
To educate on trauma-informed care and how to improve the maternity care experiences for women with a history of sexual abuse. Education on trauma-informed care intends to reduce further trauma and consequently improve the maternity care experiences, health outcomes and thus the sexual health and wellbeing of women who have a history of sexual abuse. Individuals with a history of sexual trauma experience poorer maternal health outcomes, are more likely to report their births as traumatic and are less likely to seek healthcare. It is reported that provider mannerisms and encounters are the biggest contributors to a health care experience being perceived as traumatic or triggering. Care provider discomfort due to lack of knowledge prevents appropriate opportunity for women to disclose a history of abuse, which impacts their maternity care. Topics covered are incidence, awareness, presentation, women’s current experiences of maternity care and recommendations on trauma-informed care.
03. Workforce plan to match demand for community midwives with supply in Pakistan
May 5 @ 00:00 – 00:50
Speaker: Farida Shah
Case Study: Pakistan’s key demographic health indicators are lagging far behind desired levels: maternal mortality ratio stands at 186 deaths per 100,000 live births (1), the infant mortality rate at 62, and neonatal mortality is 42, deaths per 1,000 live births and 31% are conducted by unskilled birth attendants. Also, the country is currently listed among the nations with critical health workforce deficiency and categorized as one of the 57 countries that are facing an HRH crisis (2). Community Midwives (CMWs) were introduced by Maternal Newborn and Child Health Programme as a trained cadre of birth attendants in 2006. However, several challenges persist after more than one decade of implementation and all of the provinces have still struggled with the required number of CMWs. Therefore, the Government was supported with the Identification of the optimum number of CMWs that need to be deployed in various provinces of Pakistan and make workforce projections based on the WHO HRH model.
04. Brave Actions & Strange Alliances – Addressing maternity health inequity in South Auckland, Aotearoa May 5 @ 01:00 – 01:50
Speaker: Isabella Smart
Facilitator: Paula Pelletier-Butler
The image of clean, green, Covid-free New Zealand is admired throughout the world. But behind the bungee jumps and spectacular scenery is one of the highest rates of domestic violence in the southern hemisphere. Counties Manukau District Health Board (CMDHB) community midwives service South Auckland and offer care to around 2000 women a year. CMDHB has the highest level of urban poverty and social disadvantage in Aotearoa, with high rates of homelessness, poor housing, food insecurity, transport and absolute poverty, alcohol/drug use and child protection interventions. Our population baseline health profile is poor. Most women under our care experience significant non-maternity factors which affect their engagement in care and their pregnancy outcomes. The presentation outlines how innovative midwifery service delivery has evolved in response to a deficit environment with the aim of tackling health and social inequity and challenging the impact of colonisation and racism on Maaori and Pasifika whaanau.
04. Invited Speakers :: Other educational learning methodologies to achieve Midwifery leadership (Spanish)
May 5 @ 01:00 – 01:50
Otras metodologías educativas de aprendizaje para el logro del liderazgo en Obstetricia
Speakers: Devora Pumacahua Aira and Diego Huamani
La pandemia por covid-19 desenmascaró un sinnúmero de falencias y problemas para lo que en general, no estábamos preparados en el mundo entero. Uno de estos problemas que se evidenció es la continuidad en la formación de nuevos cuadros de profesionales de la salud.
Desde el 2019 la OMS ha visto la necesidad de usar redes sociales que son de uso muy frecuente en especial por los jóvenes y a pesar de que la pandemia a alejado a los estudiantes de los centros de formación, no es un impedimento para continuar estudios. Es por eso por lo que, desde la Escuela profesional de Obstetricia, de la Universidad San Martín de Porres, los jóvenes estudiantes se han involucrado más activamente en su formación utilizando tecnologías digitales y estrategias comunicacionales que les permite empoderarse de su formación y aprender a ser líderes, de líderes consolidados, así como apoyar y alentar desde el ciberespacio a los profesionales que se encuentran en la primera línea de atención.
05. An examination of the administration of intravenous fluids to women during labour: A mixed methods research study
May 5 @ 02:00 – 02:50
Speaker: Belinda Bruce
Background: Midwives are integral to providing safe and supportive care to women in labour. One clinical intervention commonly performed by midwives is the administration of intravenous (IV) fluids. At present, there is a limited amount of robust evidence available to guide practice. To define and ensure safe IV fluid practices, research into practices surrounding the administration of IV fluids to women in labour is essential. Methods: A retrospective chart review and audit of fluid balance documentation for 107 primiparous women was conducted at a single Australian tertiary referral hospital. Secondly, qualitative semi-structured interviews of 11 Australian registered midwives were conducted to further explore midwifery behaviour and practice. Summary of findings: This study found a wide variation in clinical practice and incomplete fluid balance documentation at a single, metropolitan tertiary referral hospital. Six major themes were identified in analysis of the interviews. These included foundational knowledge and perception of risk.
05. Nacer en otro país: salud perinatal y migración en Lima-Perú (Spanish) May 5 @ 02:00 – 02:50
En los últimos años, la migración venezolana se ha extendido al mundo entero, siendo el Perú el segundo país receptor de dichos migrantes a nivel latinoamericano. El propósito de la investigación fue establecer la relación de los resultados perinatales adversos en mujeres peruanas y migrantes (la mayoría de ellas venezolanas). Se realizó un estudio observacional, retrospectivo, analítico, correlacional; de los datos del sistema de registro nacional de hechos vitales del Perú – 2018. Los resultados muestran diferencias estadísticamente significativas entre las migrantes y peruanas en relación a los partos pre-términos y mayor número de cesáreas, así como en los promedios de peso y talla al nacer, siendo desfavorables para las migrantes. Se concluye que la condición de migrante coloca a las gestantes en una situación de desventaja, siendo que las obstetras deberían considerar esta variable en los cuidados ante, pre y postnatales.
English: In recent years, Venezuelan migration has spread to the entire world, with Peru being the second receiving country for such migrants in Latin America. The purpose of the research was to establish the relationship of adverse perinatal outcomes in Peruvian and migrant women (most of them Venezuelan). An observational, retrospective, analytical, correlational study was carried out; of the data of the national registry system of vital events of Peru – 2018.The results show statistically significant differences between migrants and Peruvians in relation to preterm deliveries and a greater number of cesarean sections, as well as in the averages of weight and height at birth, being unfavorable for migrants. It is concluded that the migrant condition places pregnant women in a disadvantageous situation, and midwives should consider this variable prenatally and postnatally.
06. The birth equity in the midwifery services of pregnant women living with HIV/AIDS in Indonesia, has been realized?
May 5 @ 03:00 – 03:50
Speaker: Rizka Ayu Setyani
Facilitator: Herliana Riska and Istri Bartini
Prevention Mother to Child Transmission (PMTCT) is an effort to prevent HIV/AIDS from pregnancy, childbirth, until breastfeeding. However, stigma and discrimination are still the biggest obstacles. This study aimed to find out the stigmatization of midwives in pregnant women living with HIV/AIDS in Indonesia. This qualitative research used a case study approach. Data collection was done by focus group discussion technique in midwives group in hospitals, Public Health Centers, and private practice then analyzed with content analysis. This study showed that the most stigmatization of pregnant women living with HIV/AIDS was found in midwives’ private practice. They considered pregnant women living with HIV/AIDS as someone who had deviant behavior, and assuming HIV/AIDS was a dangerous virus. In conclusion, birth equity had not realized in the midwifery services of pregnant women living with HIV/AIDS in Indonesia. We recommend that midwives are given a correct understanding of HIV/AIDS, through seminars, or training.
06. The use of a video and photo sharing online chat group for the provision of midwife mentoring in rural Bangladesh and Rohingya refugee camps May 5 @ 03:00 – 03:50
Facilitator: Justine Powell
The presence of a midwife mentor constantly is not possible for the many health facilities and women friendly spaces providing midwife led care, supported by UNFPA, in the rural Cox’s Bazar district in Bangladesh. A weekly paper reporting system was tick-box orientated and provided no substantial feedback mechanism. This was replaced in late 2020 by an online chat (private Whatsapp group) that requires national midwifery supervisors to submit photos and videos of evidence-based practice and teaching including role-play in the facilities they supervise to the midwife mentors. This enables constant feedback and support to be provided to all health facilities between midwife mentor visits. This system also encourages shared learning and empowers professional Bangladeshi midwives, a new profession in Bangladesh, to lead education, implement change and develop leadership skills. This ‘story’ will be told by the midwife mentors of UNFPA and the Midwife Supervisors of Cox’s Bazar and the Rohingya Refugee camps.
07. Enhancing labour ward practitioner wellbeing: An insider participatory action research approach May 5 @ 04:00 – 04:50
Speaker: Claire Wood. PhD Supervision team: Mary Chambers, Jayne Marshall
Facilitator: Red Miller
Purpose: Healthcare practitioner wellbeing is threatened globally (Montgomery et al., 2019). This study explored enhancing practitioner wellbeing on one United Kingdom consultant-led Labour Ward.
Methodology: Following ethical approval and using Insider Participatory Action Research (IPAR) with approximately 900 hours non-clinical insider presence, clinical and non-clinical colleagues identified experiences enhancing their workplace wellbeing. Participants’ interview (62) and questionnaire (96) excerpts were displayed for all colleagues, and three Action Groups were initiated. Six midwives thematically co-analysed data. Preliminary findings Disseminating accounts of positive experiences encouraged behaviour change. Evaluations reported increased compassionate behaviours, teamworking, and appreciative communications within/between occupational groups; morale/positive culture; and women’s care initiatives. Feeling listened to by the insider-researcher engendered a sense of being valued. A compassionate workplace concept model encompassed themes nourishing wellbeing.
Conclusions: Using IPAR fostered wellbeing across occupational groups. A non-clinical presence reportedly sustained wellbeing. These factors, and the concept model, offer applicability to other workplace settings.
References: Montgomery, A., Panagopoulou, E., Esmail, A., Richards, T., and Maslach, C. (2019). Burnout in healthcare: the case for organisational change. British Medical Journal 366:193-195
07. The true story about the campaign “Midwives Alongside Mothers” May 5 @ 04:00 – 04:50
Speaker: Gergana Nikolova
Facilitator: Paula Pelletier-Butler
Very often, when we talk about midwifery practice and motherhood, we describe the perfect circumstances and bond between the mother and her best friend – the midwife. And don’t we all wish that were true? Sadly, more often than not, the reality is far from the ideal. The presentation will tell the story of the National campaign “Midwives alongside mothers” which was born to fulfill the need for structured and consistent evidence-based midwifery care for every mother across Bulgaria. The campaign is organised and run by the Alliance of the Bulgaria Midwives and for the last 3 years has provided nationwide free antenatal education courses, breastfeeding seminars, local intrapartum support, and now during the pandemic – additional regular online updates and support groups. The presentation demonstrates how even in difficult and challenging circumstances, a midwife’s support can be offered to every mother whenever she needs it.
08. Midwives’ knowledge of pre-eclampsia management: A scoping review May 5 @ 05:00 – 05:50
Speaker: Isabella Garti
Facilitator: Bupe Mwamba
The purpose/problem: Midwives in poorly resourced settings are engaged in pre-eclampsia management and deliver lifesaving interventions depending on the prescribed scope of practice. Therefore, we aimed to produce a synthesized summary of what midwives from around the world know about pre-eclampsia management. Method: We utilized the Joanna Briggs Institute (JBI) format and the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis extension for scoping reviews (PRISMA-Scr) checklist. Results: Following application of the inclusion criteria, twenty journal articles from low- and middle-income countries and nine guidelines were reviewed. Three main themes identified related to management whilst the last theme described how contextual factors led to either increased or decreased knowledge of pre-eclampsia. Conclusion: Midwives in some low- and middle-income countries have knowledge deficits of several aspects of pre-eclampsia management. The review suggests pragmatic steps are urgently needed to strengthen the knowledge base of practicing midwives in resourced constrained settings.
08. Success of implementing exercises in turning breech babies and increasing normal vaginal birth rates May 5 @ 05:00 – 05:50
Speaker: Latha Balasundaram
Facilitator: Red Miller
Background: Fernandez Hospitals was introduced to a training in spinning babies approach as a part of maternity services in 2018 Methods: Retrospective analysis of data collected from 340 mothers from March of 2018 to December 2020. Results: 211(62%) babies turned into cephalic from breech and 117 (35%) babies continued to be in breech. Out of the 211 women , 111(53%) had normal vaginal births and 85(40%) had caesarean sections. Out of the 85 women who had LSCS, 35(41%) women opted elective cesarean section and 46 (54%) had a trial for vaginal birth but had an emergency cesarean section. Conclusion: We should offer exercises for body balance and optimal fetal positioning to help breech babies turn into cephalic enabling women to choose a trial for a normal vaginal birth and support informed choices
09. KEYNOTE :: Are we there yet? May 5 @ 06:00 – 06:50
Keynote Speaker: Hannah Dahlen
Facilitator: Karen Wilmot
Midwifery, childbearing women and feminism are a historical triparted. We have come so far, but not far enough. We have fought so hard but have we been as strategic as we could be? Do we see the threats today clearly? Can we be braver. louder, smarter, stronger? Do we really believe in what we do? How do we reclaim the passion and re-find our hope?
10. Placental abruption in immigrant women in Norway
May 5 @ 07:00 – 07:50
Speaker: Karolina Maeland
Facilitator: Marie Buckleygray
Placental abruption is a serious complication in pregnancy. While its incidence varies across countries, the information of how abruption varies in immigrant populations is limited. The aims of this study were to estimate the incidence of placental abruption in immigrant women compared to non-immigrants by maternal country and region of birth, reason for immigration and length of residence. We conducted a nationwide population-based study using data from the Medical Birth Registry of Norway and Statistics Norway (1990-2016). The study sample included 1,558,174 pregnancies, in which immigrant women accounted for 245,887 pregnancies and 1,312,287 pregnancies were to non-immigrants. The incidence of placental abruption decreased during the study period for both immigrants and non-immigrants. Immigrant women from sub-Saharan Africa, especially Ethiopia, have increased odds for placental abruption when giving birth in Norway. Reason for immigration and length of residence had little impact on the incidence of placental abruption.
10. The contribution of non-physician clinician midwives (NPCM) in improving access to emergency obstetric care to rural communities in Ethiopia May 5 @ 07:00 – 07:50
Facilitators: Catherine Shimechero and Sylvia Hamata
Background: Ensuring quality skilled care and accessing emergency cesarean section are universally accepted strategies to avert maternal tragedies. Objectives: the aim was to explore the contribution of non-physician clinician midwives (NPCM) in accessing emergency obstetric care to rural communities in Ethiopia. Methods: An exploratory phenomenology design was done in Ethiopia in 2020. Participants were selected using purposeful maximum variation sampling technique and data was collected from 5 FGDs and 14 KII. Thematic analysis was used. Result: Three major themes were emerged from the qualitative analysis of the transcripts NPCMs has contributed to access to maternal health services and improved client satisfaction, reduce unnecessary referral and increased service volume. However, lack of policy and regulatory documents including scope of practice that recognize Clinical Midwife specialist from both MOH and RHBs found to be a major challenge for underutilization and deployment. Conclusion: Investing in non-physician midwifery education, licensing and deployment can potentially yield a significant fold return on investment in terms of lives saved
11. Supporting survivors: Midwifery care for childhood sexual abuse survivors May 5 @ 08:00 – 08:50
Speaker: Barbara Montani
The presentation will focus on midwifery care for survivors of childhood sexual abuse (CSA). CSA is defined as any act which involves a child for the sexual gratification of another person. Prevalence is difficult to determine because it is substantially under-reported, however an estimated 1 in 20 children in the UK are sexually abused. Therefore, many midwives will care for CSA survivors during their career, sometimes without knowing it. Literature shows that a common theme for many survivors is the need to feel safe and in control during the childbearing experience, as loss of control can trigger flashbacks and dissociation. Midwives should therefore employ universal precautions and practice trauma-informed care, give multiple chances to disclose abuse and be aware of the risk of retraumatisation. Sensitive midwifery practice, spiritual midwifery and advocacy for survivors are key tools midwives can employ to help CSA survivors have a positive, empowering birth experience
11. The current state of the professionalisation of midwifery in Europe May 5 @ 08:00 – 08:50
Speaker: Joeri Vermeulen
Introduction: This study aimed to explore the current state of professionalisation of midwifery in Europe. Methods: An exploratory inquiry with an on-line semi-structured questionnaire, based on Greenwood’s sociological criteria for a profession. Descriptive statistics and thematic content analysis were used. Participants were delegates from midwifery associations from 29 European countries. Results: Progress towards professionalisation of midwifery has been made through the move of education into higher education, coupled with opportunities for postgraduate education and research. Lack of progress was noted in regard to midwifery practice, regulation, and leadership. Most countries had a code of ethics as well as a midwifery association. Conclusions: Progress in midwifery education and research has taken place. However, midwives’ current roles in practice as well as leadership and their influence on health care culture and politics are matters of concern. Future efforts for advancing professionalisation in Europe should focus on the challenges in these areas.
12. Acupressure for pain relief in labour May 5 @ 09:00 – 09:50
Speaker: Loredana Zordan
Facilitator: Olajumoke Ojeleye
Description: Acupressure is the application of pressure to acupuncture points. Acupuncture points are situated on meridians containing Qi (Energy ) that flow through the body. Certain points affect areas of brain known to reduce sensitivity to pain and stress, increasing endorphin, and the production of oxytocin. Oxytocin the love hormone it is important in labour as it will help the woman to cope better with the pain, helping her to relax reducing pain perception promote relaxation and physical and emotional wellbeing. Acupressure is a non invasive technique, easy to use and offer more choice for women that want to avoid pharmacological pain relief in labour and promotes birthing partner involvement Acupressure would also allow midwives to expand their role ,becoming more complete and independent practitioner and to practice midwifery fully ,I believe that using acupressure would provide better care to women, whilst empowering them through offering choice experience .
12. Choice of birth companion among women in public health facilities in South India May 5 @ 09:00 – 09:50
Speakers: Santhoshi Jeedipally and Sowmya Thota
Facilitators: Goodson Mukosa Mpumba and Isa Abubakar
BACKGROUND: Evidence highlights that having a birth companion of choice will support women during labor and reduces the need for medical intervention. METHODS: Retrospective data and analysis of data collected from 104 antenatal mothers who birthed in public health facilities in the month of December 2020. RESULTS: When analyzed based on age groups, 62% (20-25), 23% (26-30), 3% (above 30 years of age). Amongst the 104 pregnant women, 56% are primigravida and 44% are multigravida. For the Primigravida, the first choice of birth companion was their “husband” (41%) and for multigravida women, their “mother” (50%) was the birth companion of choice. 70% of women shared that the hospital encouraged a birth companion and for 30%, the hospital did not encourage due to the COVID 19 restrictions. CONCLUSION: The results raises few questions – Is this due to a lack of awareness or hospitals policies about having husband as their birth
13. Access to antenatal care for undocumented mothers in Geneva, Switzerland May 5 @ 10:00 – 10:50
Speaker: Caterina Montagnoli
Facilitator: Joeri Vermeulen
The health of migrants is determined by complex sets of factors such as healthcare coverage or integration policies. Migrants’ sexual and reproductive outcomes are usually poorer than those of locals are. Emerging research has conversely proved that maternal outcomes and antenatal care might not always be related. To explain the paradox on migrants’ reproductive practices reported in the literature, I will make use of an interdisciplinary approach, merging clinical data collection with social interventions. In this presentation I give an ovierview of the initiatives in the field for guaranteeing access to antenatal care and improve maternal outcomes among undocumented migrant mothers in Geneva. Qualitative and quantitative data presented were the object of an interdisciplinary review of the literature study conducted by the main presenter.
13. Effect of childbirth preparation program on fear of childbirth in Iran: A review article May 5 @ 10:00 – 10:50
Speaker: Fatemeh Ghodsi
Facilitator: Carol Maringa
Normal vaginal delivery is a delivery method requiring no intervention while medical reasons and emergencies could indicate Cesarean delivery (C-section). In 2014, Iran was recorded as the third country with the highest C-section in the world. A great number of C-sections performed following maternal requests due to fear of childbirth. Thus, since 2014, Iran has been providing childbirth preparation programs for pregnant women. This article aims to provide a review of such training courses’ efficiency on reducing the fear of childbirth. Following a list of inclusion/exclusion criteria, 12 articles were reviewed. Results show that in successful programs, reducing the fear of childbirth varies widely. Also, in a few cases, programs increased maternal anxiety and concerns. This study suggests a comprehensive review of contents, materials, and delivery methods of programs. Following the results of the successful trials, a well-designed program could serve as a beneficial tool in reducing fear from childbirth.
14. Birth and the Clitoris May 5 @ 11:00 – 11:50
Speaker: Margaret Jowitt
Facilitator: Eunice Atsali
The extensive anatomy of the clitoris, revealed by Helen O’Connell as recently as 2005 through dissection and MRI, shows it to be mostly an internal organ. Its location, underneath the symphysis pubis, provides a biological explanation for the ‘G spot’ on the anterior vaginal wall, where stimulation can result in orgasm. Most sources state that the sole function of female orgasm is sexual gratification. We know that orgasm is not required for conception, however, it may well be part of the birth process. The pressure of the fetal head on the anterior vaginal wall impinges on the clitoris which may lead to movement of the pelvis, oxytocin secretion and lubrication of the outlet. If this is the case, lithotomy position would not be conducive to birth; fetal pressure exerted at the front of the pelvis would be better than pressure at the back.
14. The importance of anti-racism and decolonisation in midwifery education May 5 @ 11:00 – 11:50
Speaker: Chelsea Beckford-Procyk
Facilitator: Diane Fox
Description: Last year saw an upsurge in awareness of the system of racism, the Black Lives Matter movement gained momentum globally and more people are having uncomfortable but necessary conversations around race. In the UK Black women and birthing people are 4-5 times more likely to die due to complications during pregnancy and childbirth than their white counterparts. While the National Health Service “acknowledge and regret this disparity” they have no target to end it. We must therefore examine how the education of healthcare professionals can also play a part in dismantling racism in clinical practice. I will discuss the ways in which student midwives, women, birthing people and society as a whole would benefit from the decolonisation of midwifery education and how being actively anti-racist can positively improve practice.
15. Impacto del control prenatal en los resultados perinatales (Spanish) May 5 @ 12:00 – 12:50
Speaker: Leila Daniela Arguello
Facilitator: Julia Pecovich
OBJETIVO: Comparar los resultados perinatales adversos en mujeres que realizaron un control prenatal insuficiente o nulo vs. las que realizaron un control prenatal satisfactorio, que finalizaron su embarazo en el Hospital Municipal Ostaciana B. de Lavignolle durante el año 2019. MATERIALES Y METODOS: Estudio de tipo observacional, analítico de casos y controles. RESULTADOS: Apgar menor a 7 a los 5 minutos de vida (OR = 5.66; IC del 95%: 3.20- 10.01), mortalidad fetal (OR=11,82; IC del 95%: 4.77-29.29), bajo peso al nacer (OR=3,46; IC del 95%: 2.59-4.61), macrosomía fetal (OR= 0.62; IC del 95%: 0.46-0.85) y parto prematuro (OR = 3.73; IC del 95%: 2.84-4.90). CONCLUSIÓN: Observamos un aumento significativo en las probabilidades de que las mujeres que presentaron control prenatal insuficiente o nulo tengan resultados perinatales adversos. Generar estrategias para la captación y seguimiento de las embarazadas desde el equipo de salud, disminuiría la incidencia de resultados perinatales adversos.
English: OBJECTIVE: To compare adverse perinatal outcomes in women who underwent insufficient or no prenatal care vs. those who underwent a satisfactory prenatal check-up, who ended their pregnancy at the Ostaciana B. de Lavignolle Municipal Hospital during 2019.MATERIALS AND METHODS: An observational, analytical case-control study. RESULTS: Apgar score less than 7 at 5 minutes of life (OR = 5.66; 95% CI: 3.20-10.01), fetal mortality (OR = 11.82; 95% CI: 4.77-29.29), low birth weight (OR = 3.46; 95% CI: 2.59-4.61), fetal macrosomia (OR = 0.62; 95% CI: 0.46-0.85) and preterm delivery (OR = 3.73; 95% CI: 2.84-4.90) . CONCLUSION: We observed a significant increase in the chances that women who had insufficient or no prenatal care would have adverse perinatal outcomes. Generating strategies for the recruitment and monitoring of pregnant women from the health team would reduce the incidence of adverse perinatal outcomes.
15. Invited Speaker :: Effective learning in practice: Enabling relational, continuity of carer for future midwives May 5 @ 12:00 – 12:50
Invited Speaker: Anna Byrom
Facilitator: Jane Houston
In this presentation, Anna will share insights in to supporting and sustaining relational Midwifery Continuity of Carer by centring learning around individual childbearing women, people and their families. The session will discuss the new NMC Standards of Proficiency for Midwifery (2019) and will offer examples from education and practice. Consideration of the research aims, objectives and plans will be communicated with some guidance for developing toolkits for wider roll out and dissemination. This session will be useful for midwifery educators, students, midwives, managers, leaders and other researchers.
16. Midwives’ satisfaction with the paperless partograph as a tool for monitoring labour in a secondary care facility in Katsina State May 5 @ 13:00 – 13:50
Speaker: Aisha Salihu Abdullahi
Facilitators: Halima Musa Abdul & Afolabi Olajumoke
Description: Background: Midwives remain the major human resource for improving maternal health in communities especially by providing essential intrapartum care that is paramount in reducing maternal mortality. A paperless approach to the use of the partograph can ensure the use of the partograph by midwives in low resource settings thereby decreasing prolonged labours with its attendant morbidities. Aim: This study aimed to assess midwives’ satisfaction on the use of the paperless partograph in monitoring of labours in Katsina, Nigeria. Methodology: A descriptive cross-sectional research design was used. A total of 16 midwives employed in the delivery ward of the secondary care facility were purposefully recruited for the study. Using a researcher questionnaire, the opinion of the midwives working in the delivery ward were obtained. Results: The midwives reported satisfaction with the tool with an aggregate mean of 5.78 (constant mean = 4). Conclusion: the paperless partograph is a satisfactory tool that can be adopted for the monitoring of labours.
16. Migrant women’s experiences of respect, autonomy and mistreatment in Icelandic maternity care May 5 @ 13:00 – 13:50
Speaker: Edythe Mangindin
Facilitator: Jane Houston
As the Icelandic population has changed from being homogenous to being a multicultural society with 15.6% immigrants, it is important to address the health status and needs of migrant childbearing women as well as access to the healthcare system and experience of maternity care in Iceland. Currently, research is very limited.
Objective: The objective of this study is to test the hypothesis that migrant women experience less respect and autonomy and more mistreatment than native-born Icelandic women in maternity care. Method: An online survey including internationally standardized instruments measuring respect (MOR index), autonomy (MADM scale), mistreatment (MCPC indicators) and childbirth experience (CEQ2) will be sent out using convenience sampling. Participants: Women who have received services and given birth in Iceland 2015-2020. Data analysis will include descriptive analysis, logistic regression and regression models. Predictions: Migrant women experience less respect, less autonomy and more mistreatment than native-born women. (Data collection in progress)
17. KEYNOTE :: To access “Birth equity for all”… It has come the time to foster a movement for midwifery with women’s voices at the center (Spanish and English) May 5 @ 14:00 – 14:50
Para acceder a “Equidad de nacimiento para todos” … Ha llegado el momento de fomentar un movimiento de partería con voces de mujeres en el centro. Presentation will be in Spanish with English slides. English translation will be available for key points.
18. Respect is relational: A fractured midwife-woman relationship- focused ethnographic study of midwives’ views and beliefs about respectful maternity care in Ghana May 5 @ 15:00 – 15:50
Speaker: Jennifer Akumoah-Boateng
Facilitator: Tim Morley
Bowser and Hill seminal work increased the recognition of the mistreatment of women during facility-based birth in low-income countries. Research-led strategies have since focused on respectful maternity care for childbearing women. The perspectives of midwives have, however, received less attention. A focused ethnographic study was therefore carried out in Ghana to investigate the views and beliefs of midwives and some stakeholders in midwifery about respectful maternity care. The findings of the study indicate that respect is relational and embodies a mutual satisfaction with the outcome of care provided and reciprocal respect between the midwife and the woman. However, systemic deficiencies and constraints had resulted in women’s lack of trust in the system and midwives’ skill leading to a rejection of midwives’ identity and their care. These have become contributing factors not only to the abuse of women but of midwives resulting in the fracture of the midwife-woman relationship conceptualized by midwives.
18. Teleconsejería en salud sexual y reproductiva en Perú, durante la pandemia: TeleNanu (Spanish) May 5 @ 15:00 – 15:50
Facilitator: Raquel Kelly Justiniano
En el Perú, los servicios de atención diferenciada para adolescentes presentaban múltiples barreras, además la situación de la coyuntura actual ha provocado limitaciones en el acceso al servicio de salud. Como respuesta, los profesionales de Obstetricia desarrollaron la propuesta de Teleconsejería en Salud y Reproductiva, con participación de profesionales de Ingeniería de Sistema. El proyecto pone la inteligencia artificial al servicio de la salud, a través del desarrollo de un chatbot de Teleconsejería sobre salud sexual y reproductiva, para lo cual se requirió la creación de una página de Facebook, además, se eligieron temas prioritarios definidos por el Estado Peruano. Para el desarrollo de la Teleconsejería se adaptó los 5 pasos de la consejería en salud sexual y reproductiva al entorno virtual. Se necesitó también la implementación de una estrategia digital, que consistía en la construcción de la identidad del chatbot (TeleNanu) y la publicación periódica de información científica.
English: In Peru, differentiated care services for adolescents presented multiple barriers, in addition the current situation has caused limitations in access to health services. In response, the Obstetrics professionals developed the proposal for Teleconsultation in Health and Reproductive Health, with the participation of System Engineering professionals. The project puts artificial intelligence at the service of health, through the development of a Tele-counseling chatbot on sexual and reproductive health, for which the creation of a Facebook page was required, in addition, priority topics defined by the State were chosen Peruvian. For the development of Tele-counseling, the 5 steps of counseling in sexual and reproductive health were adapted to the virtual environment. It was also necessary to implement a digital strategy, which consisted of the construction of the identity of the chatbot (TeleNanu) and the periodic publication of scientific information.
19. Changing the face of midwifery care through advanced practice in 21st century Ireland May 5 @ 16:00 – 16:50
Speaker: Roisin Lennon
Facilitator: Carol Maringa
Background: Midwifery led care is not the norm in Ireland. A locally rising caesarean section rate and unnecessary interventions resulted in the Registered Advanced Midwife Practitioner (RAMP) led service being introduced in 2017 to normalise pregnancy for medium risk women. Aim: To offer choice and to establish a safe, quality service for the agreed caseload of women in this North West of Ireland Maternity Unit. Method: A retrospective analysis of women attending RAMP care from November 2019-November 2020 compared to the birth outcomes for similar risk women attending for obstetric led care in this North West of Ireland Maternity Unit. Findings: Maternal outcomes for those attending for RAMP versus obstetric care shows less inductions of labours, amniotomy, oxytocin, regional analgesia, episiotomy, postpartum haemorrhage and less failed inductions with higher vaginal birth rates, vaginal birth after caesarean section (VBAC) and breastfeeding rates. For the babies fewer are born preterm or weighing
19. US Midwife Student experience in the COVID-19 pandemic May 5 @ 16:00 – 16:50
Speakers: Cindy Farley and Student Panel – Christy Cannon, Charlei Coffey, Lauren Radney, Raven Fulton, and Anna Dykstra
Facilitator: Lorraine Mockford
The Corona virus pandemic has impacted all aspects of society, including the education of midwives. Clinical sites suspended student placements in the early days of the pandemic, significantly altering clinical progression and delaying graduation for many students. In person classes were cancelled and quickly pivoted to remote learning, leading to rapid curricular adjustments by midwifery faculty. Students also faced personal and professional stresses related to COVID-19 changes, such as children attending school at home, self or family members with job or income loss or alterations, and risk of exposure to the virus to self and loved ones. These changes tended to increase anxiety and obligation outside the classroom that influenced time and energy for learning. Nevertheless, midwifery students persisted toward their goals. Students in the midwifery education program at Georgetown University, US, will describe their experiences at home, and in the classroom and clinical as altered by the COVID-19 pandemic.
20. Evaluating women’s and midwives’ views of a midwife-led continuity of carer scheme
May 5 @ 17:00 – 17:50
Speaker: Shona Shinwell
Facilitator: Aleema Noormohamed
Continuity of midwifery care models are a crucial feature of maternity care policy in the UK. Robust evaluation of such models is vital to ensure women are indeed receiving high-quality midwifery care. Our qualitative evaluation of women’s and midwives’ views of a home-based continuity of carer scheme in Scotland, grounded in the Quality Maternal and Newborn Care Framework, comprised six focus groups and a one-to-one interview. Thematic analysis identified three principal themes: Organisation of care/Work culture; Information and support; Relationships. Sharing several sub-themes, these mutually co-dependent themes were crucial to the scheme’s success. The midwives’ enthusiasm for the scheme was reflected in the women’s very positive accounts of receiving tailored, sensitive and family-centred care. Midwives and women both valued the flexibility and autonomy they experienced. Women sharing their stories normalised homebirths. Providing insight into the co-dependent elements of this scheme’s success may benefit others when designing similar continuity care models.
20. Reducing maternal and child mortality in Liberia by supporting midwifery training May 5 @ 17:00 – 17:50
Speaker: Stella Nickolay
Facilitator: Elisa Segoni
The UK-based Helen Loewenstein Memorial Trust (HLMT) makes grants to student midwives in Liberia who would not otherwise have sufficient funds to train, by covering course-fees and essential study expenses. Liberia has the world’s third-lowest GDP. Its rate of maternal mortality is 80 times higher than the UK, and its proportion of qualified midwives 24 times lower. 44% of Liberian women give birth without professional help. The presentation will outline how HLMT has raised funds and twinned with a midwifery training institute in Zorza, Liberia, and is sponsoring students. Key issues include: • Building trust with key stakeholders in Liberia • Ensuring that HLMT supports the school’s and students’ needs rather than impose its agendas from afar • Ensuring that its funds are spent for the purposes intended. In exploring HLMT’s work, the presentation will cover these ethical and logistical issues and will enable participants to engage in active discussion
21. Midwives and nurses who collaborate – A Nova Scotia case study May 5 @ 18:00 – 18:50
Speaker: Danielle Macdonald
Facilitator: Tanya Belcheff
Purpose: Midwifery has been integrated into health care across Canada over the past 25 years. In Nova Scotia, midwifery services were first offered in 2009. There was a gap in understanding the experiences of midwives and nurses who worked together. Our research question was; How do midwives and nurses collaboration during the provision of birthing care in Nova Scotia? Method: In this case study, we explored feminist poststructuralist concepts of power, gender, discourses, and language in relation to the research question. Following ethical approvals, we conducted; 18 individual interviews, document review, and recorded field notes. Feminist poststructuralist discourse analysis was used. Results: We identified four main themes; 1) Negotiating Roles and Practices, 2) Sustaining Relationships, 3) Reconciling Systemic Tensions, 4) Moving Forward: A Modern Model of Collaboration. Conclusions: The findings of this study illustrated an innovative collaborative approach that could be used to support sustainable midwifery services across Canada.
21. The attitudes of Ontario midwives towards sexual and gender minorities: Results from a cross-sectional survey study (English and Spanish) May 5 @ 18:00 – 18:50
Speaker: Jennifer Goldberg
Facilitator: Niessa Meier
This study is a mixed mode (paper and internet) cross-sectional survey that explores midwives’ attitudes towards sexual and gender minority people (SGM). The need for this research is demonstrated by: (1) published literature showing midwives’ attitudes shape the care experiences of lesbian women; (2) a lack of literature on midwives’ attitudes towards all SGM. The response rate was 29.2% (n=270). Data analysis is in progress and includes measurement of Ontario midwives’ attitudes towards SGM and assessment of differences in attitudes toward SGM based on socio-demographic data. This study addresses a crucial gap at the intersection of SGM health equity and midwifery. Understanding how attitudes are shaped can help inform the process to build the capacity of midwives to provide quality, inclusive and safe care to all SGM, which could play an important role in reducing health disparities of SGM and improve their health outcomes.
NOTE: This presentation will be first in English, then in Spanish. Questions and answers will be in either language
22. Changing maternity healthcare in Israel – Women experiences and needs in view of current policy
May 5 @ 19:00 – 19:50
Speakers: Keshet Korem and Sivan Lienhart
Facilitator: Kimberley Couch
Our presentation will focus on the need for maternity healthcare improvement in Israel. Based on the results of the first survey conducted on the subject in Israel, we mapped the desires, expectations and experiences of 3500 women in relation to the period of pregnancy, childbirth and postpartum. Our results showed that women are interested in midwifery-led care, continuity of care and out-of-hospitals midwife-led birth centers. Those results are showing an urgent need for change in childbirth related policy in Israel, within which hospitals suffer from shortage of midwives and limits midwives to attend out-of-hospital births. From the obtained data and existing figures related to maternity care provided to minorities, we formulated recommendations for enhancing healthcare services, adapting them to Israeli birthing women desires. Allowing all birthing women and people to access quality public and equal maternal healthcare with no relation to their ethnicity or geographical location are aimed.
22. What about us? Women’s experiences of breech diagnosis May 5 @ 19:00 – 19:50
Speaker: Antonio Ignacio Sierra Garrocho
Facilitator: Eliza Segoni
Professional guidelines recommend midwives and obstetricians actively involve women and birthing people in making decisions about their care. To date, breech research has focused mainly on assessing the effectiveness of different management options, but little attention has been given to women’s feelings regarding breech presentation and management. This presentation will discuss the findings from a primary research undertaken by the author, which explores women’s experience of breech presentation and their perception of choice and support in making decisions with regards to breech management. In doing so, the author will provide an introduction, aims of the study and an overview of the research methods used for data analysis. The results from this research will be discussed within the context of women and birthing people’s rights in the UK.
23. Midwives as change advocates in the public system (Spanish) May 5 @ 20:00 – 20:50
Speaker(s): Ameyalli Aide Juarez Orea, Mariana Montaño Sosa, and Zeus Aranda
Facilitator: Marcela Mendoza Nunez
Since 2016, nurse-midwives have strengthened obstetric care at a birthing center and its adjacent basic community hospital in Chiapas, Mexico. In Mexico, delivery care continues to be monopolized by medical personnel who do not always provide respectful, evidence-based care. We want to share the challenges we have faced and the lessons learned during these 5 years. Since the birthing center project began, birth care practices in the facilities where we work have undergone noticeable changes: Comparing the first (August 2016-July 2017) and the last (August 2020-present) year of the project, the proportion of deliveries in which pregnant women are given the possibility to have a companion of their choice during labor has increased by 70%, while the proportion of deliveries in which pregnant women are given the possibility to choose the position of delivery has increased by 62%.
23. Uncovering the history of Canadian midwives of colour May 5 @ 20:00 – 20:50
Speaker: Karline Wilson-Mitchell
Facilitator: Niessa Meier
This project documents and analyzes the history of racialized midwives in Canada and their roles in the communities they served. Midwives of colour in Canadian settlement communities of the 19th-20th century are not represented in historical records. Many of these midwives were enslaved African refugees and indentured worker immigrants, and our goal is to trace and examine their histories. Our Pilot Study focused on Black midwives in Ontario and Nova Scotia between 1800-1970 where we looked at the many factors that contributed to the erasure of Black midwives, such as defacto segregation. Preliminary findings revealed issues of belonging and legitimacy as it relates to Black midwives’ credentials and access to health resources for their communities. This is significant in juxtaposition with reports by Black immigrants of their dissatisfaction with the child-bearing experience. Although only in the beginning stages, this project outlines the importance of uncovering a notable piece of history.
24. KEYNOTE :: The pursuit of honouring women’s childbirth narratives through visual arts-based research May 5 @ 21:00 – 21:50
Keynote Speaker: Kaveri Mayra
Obstetric violence has engulfed the world, making it an epidemic that goes unnoticed while being in front of our eyes, with birth being a part of all our lives. I was horrified when I noticed it first as an adolescent midwifery and nursing student over 15 years ago in my home state, and then around the country in India. My readings led to the realization that the problem isn’t Indian, or Asian, women were being violated and are birthing in dehumanized conditions globally, including the developed countries with well funded health systems. My research, spanning over a decade, inherently focused on bringing out these stories of birth in all it’s reality, embracing its joy, fear, shame, stigma and all its sensitivities. Visual arts based research gave me the tools to cross the barriers of power, language and cultural norms based inequities, to explore and understand women’s stories of birth involving trauma and violence. After studying through various traditional forms of data collection and analysis in research, birth mapping (an adaptation of body mapping) was born, as a revelation that presented the embodied birthing experiences in their holistic form. My work brings forth midwives and nurses perspectives and experiences, as key stakeholders in caring for women during childbirth and a crucial missing voice in finding ways to ensure respectful care. My research is embedded in critical feminist theory and uses an intersectional inequities lens to acknowledge women and birthing people’s unique experiences and how it is impacted by their positionality across the intersections. This is essential to address from the gentlest to the most traumatic forms of obstetric violence and to ensure equity in birth.
24 B. Closing May 5 @ 22:00 – 22:30 Facilitator:Linda Wylie / Cecilia Jevitt
It’s not over yet! Following the closing Keynote speaker, stay in Room 1 for a reading by Canadian poet Alice Major of her poem “Homing” (Corona Radiata – Link to the downloadable PDF https://www.alicemajor.com/wp-content/uploads/2021/05/Corona-radiata.pdf )
Then join the VIDM Organizing Committee, volunteers, and delegates as we say thank-you for another year by sharing our closing video with you.
Closing video: https://youtu.be/3BzdS8gIN_o