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Title: Celebrating global achievements in midwifery: Opportunities and challenges in 2022
Facilitator: Jane Houston
Welcome to our 2022 WHO celebration of midwives! Hear what the WHO Director-General has to say about how much WHO values the skilled, compassionate care and dedication of midwives globally.
The past two years have seen a notable increase in global attention to midwifery through the International Year of the Nurse and Midwife (2020), the publication of the 2021 State of the Worlds Midwifery (SOWMy) report and the WHO Strategic Directions in Nursing and Midwifery (SDNM) 2021-25. These reports identify four urgent priorities: strengthen midwifery leadership, strengthen quality midwifery education, invest in midwife-led care and services and improve planning and management of the midwifery workforce.
Join us to learn how WHO is taking forward these recommendations and hear the voices of midwives on the challenges they face and the progress they are making.
Find out about the impact of climate change on women and their newborns and learn why the new “hot of the press” WHO recommendations on maternal and newborn care for a positive postnatal experience will support you in providing quality post-natal to women, newborns and their families.
Facilitator: Olajumoke Ojeleye
Abstract: Pregnancy and lactation associated osteoporosis (PLO/PAO) is a rare and complex condition in which low bone density during pregnancy or lactation causes low-trauma fractures, typically in vertebrae, pelvic structures, or the femoral neck. Timely diagnosis is key to minimizing long term mobility impacts. The absence of descriptive statistics and qualitative data about the presentation, recovery, and psychosocial dimensions of PLO/PAO represents a striking gap in existing research, which the presenters sought to address with a qualitative survey of members of an international PLO/PAO support group. This presentation will provide background on PLO/PAO and present original survey findings related to disease presentation, treatment, and recovery time. The emphasis of discussion will be on how midwives can effectively identify this condition early and spearhead development of an effective clinical support team for those diagnosed. Navigating care conversations about pregnancies following a PLO/PAO diagnosis will also be discussed.
Speaker: Juliana van Olphen Fehr
Facilitator: Cindy Nelly
The Optimality Index is a performance measurement instrument whose scoring system is revised to include a learning component that supports midwives as they care together when touching (using evidence-based practices), measuring (reflecting on impacts of care), and teaching (mentoring). Background: Optimality Index items describe evidence-based practices or optimal outcomes occurring within four perinatal domains: antenatal, parturition, newborn condition, and maternal condition. Researchers using the original Optimality Index graded these domains together producing one score. Midwives using the revised Optimality Index can grade each domain separately during care to discover its optimality. Midwives can also reflect together upon the relationships between practices and outcomes in different domains. An Optimality Index-US will be used during the discussion to focus on item grading, measuring relationships between domains, and using touching, measuring, and teaching to prevent interventions. Summary: Since 1996 researchers worldwide have used the Optimality Index to support the optimality of midwifery…
Title: Mujeres y parteras: Fortalecimiento en red / Women and midwives: Strengthening Through Network
Invited Speakers: Taumanova Alvarez Acosta and Sonia Cavia
Facilitator: Paola Wilkin
RELACAHUPAN (Red latinoamericana y del Caribe por la humanización del parto y nacimiento )
El objetivo de la red está centrado en apoyar y promover la consolidación de modelos respetuosos de atención a las mujeres y familias durante sus procesos de gestar, parir, nacer.
Siendo múltiples los contextos y realidades en Latinoamérica y el Caribe, las parteras siguen siendo personas claves en el cuidado de la vida, no solo por su pertinencia social , si no por su valiosísimo conocimiento y auténtica empatía.
Queremos compartir en este espacio, lo que es la RELACAHUPAN, algunas iniciativas que suman al reconocimiento de las parteras y dignificar su práctica en los distintos contextos , así como promover las alianzas en red como estrategia para seguir concretando en el cotidiano los derechos de las mujeres y de las mujeres parteras.
RELACAHUPAN (Latin American and Caribbean Network for the Humanization of Childbirth)
The objective of the network is focused on supporting and promoting the consolidation of respectful models of care for women and families during their pregnancy and childbirth processes.
In the face of multiple contexts and realities in Latin America and the Caribbean, midwives continue to be key in the care for life, not only because of their social relevance, but also because of their invaluable knowledge and authentic empathy.
We want to share in this space, what RELACAHUPAN is, some initiatives that add to the recognition of midwives and to dignify their practice in different contexts, as well as to promote network alliances as a strategy to continue concretizing the rights of women and women midwives in daily life.
Facilitator: Belle Bruce
Background: Consensus-based guidelines encourage midwives to inform women about normal fetal movements and when to report concerns, despite limited information to guide clinical practice.
Method: We undertook an online New Zealand-wide survey of women at 28 weeks gestation.
Results: Data were available on 1334 participants. Fetal movements were stronger in the evening (950, 71.2%) and ‘busy times’ were more common in the evening (937, 70.2%). During the last week episode of ‘wild-crazy’ fetal movements (1069, 80.1%) and fetal hiccups (855, 64.1%) were reported by the majority. Two-thirds (857, 64.2%) had received information about what fetal movements to expect and 58.0% (774) would like more information. Midwives were the most trusted source of information (942, 70.6%). Most women (1113, 83.1%) had been concerned about fetal movements.
Conclusions: Nearly half the pregnant women surveyed would like more fetal movement information. This could include diurnal pattern and other common characteristics of normal fetal…
Speaker: Lianne Schwartz
Facilitator: Paola Wilkin
As midwives, we’re always caring for others. Caring for ourselves, though, is what keeps midwifery sustainable. Even before the pandemic, midwives were facing burnout, anxiety, depression and chronic stress in unprecedented numbers. The last two years have only increased the challenge.
Midwives are there at the very juncture of life’s beginning. We are constantly faced with the unknown, with varying degrees of responsibility and skill in that process. Supporting birth can be hard, and midwives as well as women can leave a birth feeling traumatized and in need of support. It’s vital that we understand and begin to cultivate integration and healing of trauma we’ve witnessed and experienced as a midwife.
This talk encourages self-reflection as well as sharing tools and practices midwives can use to support themselves and colleagues through times of turmoil.
Speaker: Birhan Tsegaw Taye
Facilitator: Catherine Salam
Background: In low and middle-income countries, many childbirths still occur at home unskilled attendants. This study assessed reasons for traditional birth attendants’ preference, utilization, and associated factors.
Methods: A cross-sectional study was employed among 416 women. Study participants were recruited by a simple random sampling technique. Data were collected using a pretested and interviewer-administered questionnaire. A multivariable logistic regression model was fitted and the level of significance was determined at a p-value of 0.05.
Result: About 31.5% of the participants were used traditional birth attendants (TBAs) in their recent birth. Marital status, age marriage, time to reach a health facility, know danger signs, attitude towards TBAs, antenatal care follow-up, and listening radio were predictors of TBA utilization at birth.
Conclusion: Still TBAs are women’s first choice of birth attendants. Antenatal care and health education programs might enhance skilled delivery utilization and strategies targeted on reasons for TBAs preference over skilled attendants.
Please be sure to check the poster Birhan Tsegaw Taye prepared on this topic. https://vidm.org/vidm-2022-research-posters/
Facilitator: Gita Nirmala Sari
Obstetric triage is usually undertaken by a midwife and involves identifying the woman’s presenting problem and conducting physiological and vital signs assessment. Triage of a pregnant woman poses challenges, as the physiological changes associated with pregnancy do not match the general parameters of standard emergency department triage measures. For these reasons, the Birmingham Symptom-specific Obstetric Triage System (BSOTS) was developed to standardise triage within maternity care, to support the identification, prioritisation, and care of women who present to health services with unexpected pregnancy concerns. This presentation will present findings from a mixed-method evaluation of the implementation of the BSOTS into an Australian level 6 tertiary care service which provides maternity care to over 6500 women per year. This is the first site in Australia to implement BSOTS. Overall, the findings suggested that the BSOTS provides a good framework for triage and has benefits for both women and staff.
Speaker: Olajumoke Ojeleye
Facilitator: Cindy Nelly
Aim: The purpose of the concept analysis was to further clarify the term “self-efficacy” and translate it into the field of PMH in relation to the role that PNMs should perform. Self-efficacy (SE) is important to PNMs in PMH practice because it is linked to maternal and child health outcomes. PNMs levels of SE can increase or hamper their motivation to promote PMH or support women who are suffering from PMH disorders including postpartum depression.
Design: A review was conducted using Walker and Avant method.
Results: A total of 23 studies on the SE of PNMs in promoting PMH published between 2010 and 2021 were identified. Surrogate terms of SE were identified and clarified based on how their attributes differed from SE.
Conclusion: SE, as the main predictor of PNMs’ behaviour, plays a significant role in PNMs’ competence in delivering PMH care.
Speaker: Giyawati Yulilania Okinarum
Facilitator: Terri Downer
Background: Indonesia has been affected by the COVID-19 pandemic, including in the context of exclusive breastfeeding. Whereas breastfeeding is the safest for babies in disaster situations and the success of breastfeeding is a social and collective responsibility, also a woman’s decision. The focus of this study is to explore the strengthened elements of breastfeeding experience during the COVID-19 pandemic.
Method: This is an exploratory qualitative study design, conducted in Yogyakarta Special Region Province, with nine lactating mothers participated in the study. Interviews were audio-recorded, transcribed, translated and thematically analyzed. Results: Strengthening elements in breastfeeding mothers during the pandemic were: maternal affection, support system from family and community, and coping strategy for reducing stress during breastfeeding.
Conclusion: Breastfeeding is a baby’s right even though in a pandemic situation, thus achieving more satisfactory clinical practices that encourage breastfeeding, the support process should include a subjective and social component.
Speakers: Yilkal Dagnaw Melesse and Ambaye Minayehu Zegeye
Facilitator: Paola Wilkin
Introduction: Discontinuation of these methods exposes a woman to unwanted pregnancy, unsafe abortions, and unplanned births. Despite the improvement in the availability and utilization of these methods, discontinuation is becoming high. Methods: health facility-based cross-sectional study was conducted on 415 participants and data entry and analysis were done. A P-value of less than 0.05 was considered a statistically significant factor for discontinuation.
Results: The overall proportion of discontinuation of long-acting reversible contraceptives was 66.3% (95% CI:61.42-69.13).No formal education (AOR=.49; 95% CI:0.30-0.82), primary school education (AOR=.39; 95% CI:0.18-0.81), desire for pregnancy(AOR=2.57; 95% CI:1.64-4.02), past history of modern contraceptive utilization (AOR=2.01; 95% CI:1.19-3.38), lack of counseling about benefits (AOR=1.68; 95% CI:1.08-2.62) and side effects (AOR=1.95; 95 CI:1.21-3.16) were the associated factors for discontinuation.
Conclusion: The overall discontinuation of long-acting reversible contraceptives was high. Education, the desire for pregnancy, past history of utilization, lack of counselling, and side effects were factors for discontinuation.
Speaker: Rizka Ayu Setyani
Facilitator: Gita Nirmala Sari
Safe motherhood in midwifery care entails providing all women with the knowledge and resources necessary to navigate pregnancy and delivery safely. However, the increase in maternal and infant mortality is still a global problem, especially in Indonesia. We initiated the Sekolah Komplementer Cinta Ibu (SEKOCI) program in Indonesia from 2020 until now. The aim was to realize safe motherhood-based antenatal care services with a holistic complementary midwifery care approach. The SEKOCI approach method is hybrid, combining an offline class system by volunteer midwives and online telehealth. The focus of our activities is to share relaxation techniques through massage, yoga, and self-healing. We also empower pregnant women and families to monitor and care for pregnancies independently during the COVID-19 pandemic. As a result, there is a decrease in complications from pregnancy to delivery and postnatal. We recommend the government scale up the SEKOCI program so that it has a broad impact.
Speaker: Susan Smith
Facilitator: Belle Bruce
This presentation discusses the influences on vaccine hesitant parents and pregnant women. Immunisation is universally accepted as one of the most significant health initiatives in recent times. However, vaccine hesitancy is increasing in Australia and other high- and middle-income countries. The recommendation of a midwife is a predictor for vaccine uptake. A qualitative exploratory online survey of vaccine hesitant parents and pregnant women (n=106) was conducted in 2021. Pregnant women and parents obtained most of their immunisation education from midwives, nurses and general practitioners. Vaccine decision-making was influenced by vaccine safety concerns, the sources of information, the use of alternative therapies, diet, and lifestyle factors. Midwives are a popular, respected and a vital source in the provision of accurate and timely immunisation education. However, further education is required at an undergraduate level to adequately prepare them for their role of listening to and educating vaccine hesitant pregnant women and parents.
Speaker: Eleni Hadjigeorgiou
Facilitator: Fridah Ndinda
Background: The current COVID-19 pandemic is a unique stressor with potentially challenging and negative consequences on the experiences of pregnant and postpartum women.
Aim: To examine the impact of the COVID-19 pandemic and the associated government-imposed measures on the experiences, concerns and needs of pregnant and postpartum women in Cyprus.
Method: The cross-sectional study was conducted from July 2020 – January 2021. A total of 695 women, 355 adult pregnant and 340 postpartum women residing in Cyprus were surveyed.
Results: The great majority of the participants (80.9%) interpreted the impact of the COVID-19 pandemic on their life as negative. Our findings indicate that 74.1% of the pregnant women were concerned about changes impacting the presence of their family at birth, 57.2% about their child’s health, and 43.1% about changes related to perinatal care. Postpartum women’s concerns were mainly related to the welfare and health of their child (70.3%), while half of them (49.1%) expressed concerns about how they were going to care for their baby. Qualitative data revealed emerging themes as the basis of the pregnant and postpartum women’s concerns and needs.
Conclusions: The women’s concerns emphasized the need for the development of specialized, evidenced-based support systems which are essential particularly in pandemic-like situations, when pregnant and postpartum women are more vulnerable to isolation.
Facilitator: Linda Wylie
Abstract: We will present the findings from the mixed methods feasibility and effectiveness study including knowledge and skills assessments results from baseline, endline and a 3-month follow-up of a four-arm pilot study. The pilot-study tested short (1.5 day) vs. spaced training (5 sessions bi-weekly) approaches of the ENC Now! content (Prepare for Birth, Routine Care, The Golden Minute-Stimulation, The Golden Minute Ventilation, and Continued Ventilation) with and without integration of the Safe Delivery App along with 3 months of human-prompted self-directed learning for repeated practice in a semi-urban context (Debrebirhan) in Ethiopia. At the outset of this project little evidence was available on the effectiveness of remote training and the project was set up with a rigorous monitoring and evaluation system to generate insights into what works and what does not.
Facilitator: Catherine Shimechero
The Purpose: The study tested the user experience and knowledge building effectiveness of the Safe Delivery App (SDA) among public facility nurses in Bihar, India. The SDA is a smartphone application that provides health care providers with direct and instant access to evidence-based and up-to-date clinical guidelines on BEmONC.
Method or Design: A pre-post- test assessed nurses’ knowledge involving 229 participants, across four topics: Active Management of Third Stage of Labour, Neonatal Resuscitation, Post-partum hemorrhage (PPH), and Pre-Eclampsia/Eclampsia at baseline and three-months after using the SDA.
Results: There was a significant improvement in knowledge from baseline to end. The greatest increase was observed for pre-eclampsia/eclampsia and the least for PPH. The participants considered the SDA useful.
Conclusion: An upward trend in knowledge was observed from baseline to end-line, yet there remains scope for further improvement. Prolonged use of the SDA could support improvements in knowledge over a longer period.
Speakers: Belayneh Ayanaw Kassie
Facilitator: Ally Anderson
Cross-sectional study was conducted from June to August 2020 among 1,691 Midwives in Ethiopia. Simple random sampling technique was used to select study participants and data collected using telephone interviews. Data entered using the Google forms and analyzed with SPSS. Bivariate and multivariable logistic regression analyses employed.
The overall prevalence of depression 41.1% [95% CI: 38.6, 43.7], anxiety 29.6% [95%CI: 27.3, 31.8] and stress 19.0% [95% CI: 17.0, 20.8]. The sex of midwives (AOR=1.35), working in rural area (AOR=1.39), poor knowledge towards COVID-19 (AOR=1.40), poor preventive practice (AOR=1.83) and substance use (AOR=0.31) were significantly associated with depression. Moreover, working in public health facilities (AOR=2.44), poor preventive practice (AOR=1,47) and poor attitude (AOR=2.22) were significantly associated with anxiety. Stress were affected by working in rural areas (AOR=0.57), substance use (AOR=2.06), poor knowledge (AOR=1.44) and poor practice (AOR=1.60).
Study findings show high rates of Depression, Anxiety and Stress among midwives in Ethiopia.
Speaker: Laura Godfrey-Isaacs
Facilitator: Bupe Mwamba
Abstract: Maternal Journal is a global community movement of journaling groups, thousands on social media and a new publication. It was born in response to a need to support, through creative journaling the mental health and wellbeing for those going through pregnancy, birth and new parenthood.
It builds on the significant feminist tradition of journaling by supporting and inspiring anyone going through the transformation into life as a parent. Participants are guided through unique exercises that will help to raise voices, process thoughts, feelings and emotions and boost wellbeing through creative practices.
Maternal Journal’s beautifully illustrated and easy-to-use guides are led by artists, psychotherapists, midwives, poets, authors, doulas and activists to help explore creativity and empower women and birthing people to share their experiences and take time for themselves.
Speaker: Mariapia Dado
Facilitator: Liz McNeill
Water immersion during labour and birth has been acknowledged worldwide as a safe option for low-risk pregnant women. The extent of use of water immersion in the Republic of Ireland, however, is largely limited, as few maternity units have installed birthing pools. To explore women’s experience of water immersion during labour and birth in a hospital setting in Ireland, a qualitative study was undertaken. Findings suggest that water immersion assists in preserving the physiological processes of birth even in a medicalised/hospital birth setting. However, a lack of information and accessibility created a sense of anxiety for women that opted for waterbirth leading them to express dissatisfaction with the current model of maternity care that neither promotes nor advances the availability of waterbirth as a labour and birth option. Water immersion can be considered a valuable option for ensuring both positive childbirth experience and evidence-based midwifery care.
Speaker: Yeshinat Lakew Ambaw
Facilitator: Caroline Maringa
Background: One third world population is adolescents. Promoting healthy practices during youth, and taking steps to better protect young people from health risks and prevent them from health problems in future adulthood. Objective: To assess reproductive health services utilization and associated factors among youth in North Shoa zone town administrations, Amhara region, Ethiopia 2021 Methods: A community-based cross-sectional study design was conducted from November 01/2020 to January 01/2021. A multi-stage sampling technique was used. Result: The prevalence of reproductive health services utilization was found to be 34.8% with (95% CI:30.9,38.5). Sex, occupational status, living arrangement, discussed RH issues, heard about youth-friendly reproductive service, the existence of youth-friendly reproductive health service facility around their living area, convenient working hours, person preference was found to be significantly associated with reproductive service utilization. Conclusion: Reproductive health service utilization among youth was found to be lower. Therefore, need health promotion and education regarding RHS.
Speakers: Ambaye Minayehu Zegeye and Yilkal Dagnaw Melesse
Facilitator: Caroline Maringa
This study was designed to determine the determinants of fetomaternal outcomes of antepartum hemorrhage and reduce poor fetomaternal outcomes.
It complicates 2-5% of all pregnancies with an increased rate of maternal and perinatal morbidity and even mortality still now.
A Hospital-based Case-control study by using secondary data was conducted from April, 19 to May 20, 2021, at Awi Zone Public Hospitals with a sample size of 448 with a ratio of 1:1 cases to controls.
Determinants that were statistically associated with poor fetomaternal outcomes were no antenatal care follow up [AOR= 2.5, 95% CI 1.49,4.2], rural residence [AOR=1.706, 95%CI 1.09,2.66], delay to seek care &;12 hours [AOR=2.57, 95% CI: 1.57, 4.23] and advanced maternal age 35 [AOR= 3.43, 95% CI 1.784,6.59].
This study revealed that residence, Delay to seek care &; 12 hours, not having Antenatal care follow up and advanced maternal age were determinants of fetomaternal outcomes of Antepartum hemorrhage.
Title: Celebrating 100 years of ICM and exploring frameworks for the future
Keynote speaker: Sally Pairman
Facilitator: Ally Anderson
The International Confederation of Midwives turns 100 this year and with such a big anniversary comes a reflection on the past and a need to look forward to what the next 100 years will bring. Through this session, Sally Pairman, Chief Executive of ICM, will explore what it means for ICM in their centennial, key areas of reflection and learning, and she will present ICM’s updated professional framework which aims to support and strengthen midwives and midwifery for years to come.
Speaker: Sophie Rayner
Facilitator: Diane Fox
My proposal is for a discussion on the care of autistic women and birthing people in maternity care. I am impassioned by this as an autistic person myself and have noticed the acute lack of research of autism spectrum disorders (ASD) in pregnancy. With increasing numbers of women diagnosed with ASD, it is a certainty that we will see increasing numbers of people with this diagnosis coming through maternity services and therefore must be aware of how we can adapt to suit their needs and make pregnancy and childbirth a positive experience for them.
Speaker: Hadiza Mohammed Sani
Facilitator: Fridah Ndinga
The study was carried out to determine the opinions of couples on who decides the place of baby’s birth and also their preferred place for delivery. Quasi-experimental research design was used for the study where non- randomized control group design was used, with a control and study group. Ethical clearance was given by Kaduna Ministry of Health. The result of the study showed that decision on place of birth for the baby is mostly done by both husband and wife in the two groups (13.2% for the control and 16.9% for the study group). The results also showed that 30.1% and 34.6% of mothers in the control and study group would prefer to have their babies delivered in clinics or hospitals. Among the husbands, 30.1 and 36.0% would prefer to have such babies delivered in clinics or hospitals.
Speaker: Elvis Anyaechiechukwu Okolie
Facilitator: Caroline Maringa
Cervical cancer is a disease of inequality and the commonest gynaecological cancer affecting women in low- and middle-income countries (LMICs) including Nigeria. While vaccination and screening have been shown to prevent cervical cancer, LMICs still account for more than 85% of the disease burden. Female health workers (FHWs) are expected to play a significant role in driving screening efforts. This study systematically investigated factors influencing cervical cancer screening among Nigerian FHWs. Upon completion of a systematic literature search involving six databases, 15 primary studies involving 3392 FHWs in Nigeria were included in this study. While FHWs had good knowledge and positive attitude towards cervical cancer screening, screening uptake was poor. Prevalent barriers included fear of positive results, cost, low-risk perception, and lack of time. Therefore, it becomes critical to implement interventions that translate FHWs cervical cancer knowledge and attitudes into screening uptake and recommendation for other women.
For additional information see: Research paper: https://onlinelibrary.wiley.com/doi/10.1002/cnr2.1514
Speakers: Anitah Kusaasira
Facilitator: Liz McNeill
Communication between deaf persons and health workers has been a great challenge. A number of the deaf persons are unable to access proper health care services because of the lack of certified sign language interpreters in our health facilities. Also the available certified sign language interpreters are expensive to hire and maintain. Besides, using sign language interpreters compromises patients’ privacy as they may not fully express their concerns leading to misdiagnosis, medical errors, non adherence to treatment and poor health outcomes. The Digital Speech Assistant has developed an application that will aid effective communication between deaf patients and health workers enabling health workers to take accurate history, make right diagnosis, provide clear treatment instructions and ensure privacy.
Contributor: Nura Izath
Speakers: Amina Abdulraheem
Facilitator: Halima Musa Abdul
Adolescent mothers are at increased risk of having preterm birth, low-birth-weight babies and low knowledge of exclusive breastfeeding. The study aimed to evaluate the effect of nursing educational program on exclusive breastfeeding of adolescent mothers attending Antenatal clinic in Zaria Metropolis. A quasi experimental design using a multistage sampling technique to obtain data from 302 adolescent mothers. Data were collected using structured and validated interviewer-administered questionnaire and observation checklist before and after the intervention. Descriptive statistics, unpaired-sample t-test and segmented Poisson regression were used to evaluate the effect. At post-tests, the mean knowledge and practice scores of mothers in the intervention group improved significantly (P value 0.05) at first week, 6th week, 10th week, 14th week and 6th month postpartum. Mothers in the intervention group were more satisfied with their role of exclusive breastfeeding than those in the control group (p-value 0.0000). There is a need for midwives to continue health educating adolescent mothers on exclusive breastfeeding…
Co-authors: Hayat Gommaa and Ayishetu U Musa-Maliki
Speaker: Sangy Manjini Anandaraj
Facilitator: Margaret Aoro Adongo
Problem:There are challenges in implementing midwife-led care in LMICs. This mixed- methods systematic review aims to identify, synthesise and report the factors that facilitate and hinder the implementation of midwife-led care for midwives in LMICs.
Method:The review was conducted using a structured search strategy and seven electronic databases. Research studies expressing views of those involved in or affected by the implementation of midwife-led care were included. The Mixed Methods Appraisal Tool (MMAT) was used to assess the methodological quality of included studies. The data was synthesised using the framework thematic synthesis.
Findings show that midwives in LMICs were less confident in providing midwife-led care because of inadequate knowledge and skill. Additionally, lack of resources in health facilities hindered midwives caring for childbearing women.
Conclusions:Training to global standards is required to strengthen professionalism in midwifery. Besides, adequate human and financial resources are likely to contribute greater implementation success in LMICs.
Speaker: Gill Allen
Facilitator: Diane Fox
There is not a midwife in the world who would say “I do not like my job” or “I do not care” and yet many are leaving the profession, some with sadness, some with anger, and some because they have been broken .
Here at Portsmouth we were on the same track, but things are improving. I will share the journey, a difficult, challenging, yet successful story of how we implemented the Continuity of Carer model benefitting mothers and babies, as well as midwives.
I will explain the project and the phases of implementation, together with how the challenges we faced were overcome. I will explain how the passion has been brought back to midwifery and alongside the sharing of statistics I will share the feedback that has been received from the families and our midwives.
Title: Women at the centre of breech care: The role of specialist midwives
Keynote Speaker: Shawn Walker
Facilitator: Elisa Segoni
This session will look at emerging research led by midwives about how we can transform breech services to keep the women and people who use them at the centre of our care. We will look at findings and progress in the OptiBreech Trial feasibility study and the decade of research that underpins the OptiBreech Care pathway for term breech presentation. And we will discuss the role of leadership through research in growing our profession.
Speaker: Yvonne Greig
Facilitator: Eunice Atsali
Obese pregnant women (BMI & 30kg) are at increased risk of developing complications during pregnancy, labour and birth. Furthermore, their offspring are at risk of short- and long-term health complications. Midwives are ideally situated to inform women about risks and to support them in optimising their health. How midwives raise and maintain dialogue with women about this health issue is not well understood. A qualitative research study was conducted drawing on the principles of social constructionism to explore how midwives practiced and maintained dialogue with women about the risks of living with obesity. Data were analysed thematically, three themes emerged: “situational context of practice”, constructing partnerships with women, midwife as a public health agent. Midwives appeared to have learnt their communication skills informally, and utilised institutional questionnaires as a mechanism for opening “sensitive” conversations. This approach appeared to guide appointment dialogue but risked the woman-centred philosophy of midwifery care. Providing educational opportunities for midwives with respect to consultation education in midwifery curricula may strengthen midwifery practice with respect to discussing sensitive topics.
Speaker: Kusmayra Ambarwati
Facilitator: Bupe Mwamba
MOMMY MOMBI program is a pilot program that aims to prevent stunting. It was initiated by the ICM in 2018. Education and mentoring are carried out from pregnant women until their babies’ age of two years. It used a combination of various forms of meetings and educational media. This study was one of a form to assess the project with a qualitative approach. It aims to find out changes in maternal behaviour and knowledge related to stunting prevention more deeply qualitatively. The study used qualitative methods with a case study approach complemented by verification. There were informants of program participants and midwives. After participating in the MOMMY MOMBI program, they felt the material provided so far that was obtained many differences, especially in the practice of breastfeeding and complementary feeding. Mothers began practising the gold standard of proper baby feeding. Education with direct contact is best.
Facilitator: Mary Bada
Clinical guidelines and scientific research over the past 10 years show that freedom of mobility during labour and birth has positive effects on some maternal and neonatal outcomes. Important limitations are that studies do not fully capture the richness of the concept of freedom of mobility, the birth experience and care context.
As a midwife, it is important to encourage women to move during labour and birth, to let women choose freely the positions they feel are most beneficial to them and their child and to build their trust and confidence in staying mobile during birth. In case of labour dystocia, midwives play a crucial role in advising specific remedial labour and birth positions. The knowledge about freedom of mobility within a physiological birth framework is a fundamental midwifery skill. And midwives need to be given (back) the freedom to apply this valuable knowledge in promoting better birth outcomes.
Facilitator: Susan Kiamba
Scaling up quality midwifery and strong midwifery leadership has been identified as a “global priority”, as evidence demonstrates that the provision of high-quality care by midwives can avert the majority of maternal and neonatal deaths worldwide. Yet the latest “State of the World’s Midwifery” report outlines how midwifery work remains undervalued. This may be in part due to the integration of midwifery and nursing along with a lack of representation and guidance for strong leadership for the midwifery profession.
Therefore aim of this project was to:
- Measure and compare the professional identity of both midwives and nurse-midwives
- Collect examples of strong midwifery leadership and explore how such leadership may be upscaled and sustained.
- Invite midwives/nurse-midwives to consider how they might instantiate or ‘represent’ the midwifery profession to the world.
This presentation will share ‘Midwives In Focus’, our early analyses and results including international representations of midwifery.
Speaker: Charlotte E Morris
Facilitator: Lorraine Mockford
Background: Health care providers may experience multiple adverse events during their professional career. As a result of being directly or indirectly involved in the adverse event, health care providers are considered second victims. The second victim phenomenon leads to significant physical, psychological, and psychosocial sequelae that negatively impacts their personal and professional lives for either a short or long period of time. emergencies. The literature shows midwives may be equally if not more affected by adverse events because of the intimate nature of their care.
Discussion: Since health care providers have a high probability to encounter adverse events they should be aware of this phenomenon, associated symptoms, appropriate treatment, and peer support options to avoid consequential negative outcomes.
Conclusions: It is imperative that health care providers, staff, and health care organizations become involved in developing programs within their institutions or practices that actively and efficiently support second victims.
Speakers: Halima Musa Abdul,
Facilitator: Cynthia Pitter
Growing recognition of the impact of pregnancy loss and neonatal death has led to research focusing on the emotional burden on bereaved families. Women’s traumatic birth experiences have received a lot of attention; however, nothing is known about men’s experiences of attending a traumatic birth in Nigeria. This paper explores men’s experiences of childbirth that were traumatic for them. The study used a phenomenological approach. Respondents were recruited via social media platforms. Interviews were conducted among seven participants through Skype and face to face. Thematic analysis was used for data analysis supported by NVivo 12. Themes generated include experiences of the trauma, impact on fathers’ well-being and surviving the trauma. Men may experience severe psychological distress during and after childbirth. Therefore, there is an urgent need for the midwifery team to understand the impact of men’s attendance during traumatic childbirth in order to improve their well-being and their family.
Co-authors Balarabe Fatima, Abubakar Isa, Rufai Ahmad
Title: Holding space…. Together
Speaker: Céline Lemay
Facilitator: Paloma Terra
Midwives are important health professionals making a difference in maternity care. They are often evolving in a context of institutions structured by technomedicine and industrialized vision of birth and work. Researches have been done on places of birth, midwives, women and families. However, “ humans are creatures who participate to spaces that are unknown to physics” (Sloterdijk, free translation from French). Then, we can explore seven spaces (like the seven directions of native people) concerning the world of birth: one with light, spirits, soul and joy, one with science, medicine, EBM and numbers, one with hands, bodies, skills and senses, one with words, stories, poetry and knowledges, one with darkness, fear and tears, one with technology and machines and finally one with human birth processes, transformation, passages (including death) and imperfection. These spaces are all connected and weaved at different times and weight around the birth processes. These spaces are not in a particular order, line or even circle…. they are part of a sphere, the planet birth…. where are the midwives in this world? We will explore their role as human beings caring for humanity, holding space and welcoming life processes with their heart and hands. There is no recipe. We need humility and wisdom. As midwives, maybe a shared consciousness can contribute globally to hold the birth space and care…. together.
Speakers: Cindy Farley and Georgetown University Cohort 35 Midwifery Students: Kelly Grant; Zoe Pappas; Tayla Tingstad; Fleure Fraser; Jennifer Pearcy
Facilitator: Lorraine Mockford
A peer is someone that shares common experiences and social similarities. A midwifery student peer can provide the deeply felt empathy, encouragement, and assistance that comes from going through similar experiences in their midwifery education. Peer mentors and mentees both gain from the establishment of a reciprocal relationship of support. Limited evidence regarding peer support among midwifery students suggests that benefits for mentors include the opportunity to develop mentorship and leadership skills while benefits for the mentee include enhanced confidence and practical advice to optimize their educational experience.
Midwifery students expected much of their classroom work to be in the remote environment when they enrolled at Georgetown University, in fact, a number of students chose Georgetown for this very reason as they are place bound with family and work obligations. They are able to maintain these ties with occasional trips to campus for simulation learning. However, COVID-19 caused faculty and students to pivot to an entirely remote learning environment for didactic education. Peer support has been even more precious and critical during this time. These students are looking forward to their first on campus experience in April 2022 in the face of uncertain and evolving conditions imposed by the pandemic. Please come hear their stories of peer support and share yours at our VIDM Student Cafe.
Facilitator: Jackson Ngaruiya Muchiri
In the United States, tranexamic acid (TXA) is an approved antifibrinolytic agent for women experiencing heavy menstrual bleeding. Large, multi-site studies have also demonstrated TXA effectiveness in reducing death from blood loss following trauma and major surgery and most recently, obstetric hemorrhage. As a result, WHO recommends the use of TXA in obstetrics – specifically for primary management of the most common type of obstetric hemorrhage, postpartum hemorrhage (PPH). In the U.S., professional organizations recommend TXA as an adjunctive therapy for PPH. The use of TXA to prevent PPH in vaginal and cesarean delivery is also being studied from population and risk-based perspectives. This presentation will present the a) use of TXA in the context of the physiologic changes of pregnancy b) use of TXA in the treatment of PPH in the United States, c) state of the science globally with respect to prophylactic use TXA use to prevent PPH.
Speaker: Grace Omolade Daniel
Facilitator: Ally Anderson
Disrespectful maternity care constitutes a human rights violation that undercuts women’s autonomy. The expansion of knowledge about the science of midwifery is key to providing better patient care, improving health, and evaluating outcomes. This study therefore aimed at assessing student midwives knowledge and attitude regarding respectful maternity care in Jos, Plateau state. We conducted a Descriptive cross sectional survey among 235 student midwives. Knowledge measures of RMC and rights of women were developed using 24 items, while 8 items assessed attitude of these students towards RMC. Findings revealed that majority (90.7%) of the respondents had good knowledge about respectful behaviors in maternity care, majority (77.5%) had good knowledge of the rights of childbearing women. The attitude of students was however negative towards providing respectful care. Respectful care must be modeled during training for these students so that it can have an influence in their practice as midwives in the future.
(Grace O. Daniel1*, Nifemi Omoniyi2, Bonji Gaknung3, Grace Onyejekwe4, Eunice Ari5, Patience Kumzhi6, Nadyen Shikpup7
Department of Nursing Science, University of Jos, Jos, Plateau State, Nigeria)
Speaker: Ally Anderson
Facilitator: Jackson Ngaruiya Muchiri
The caesarean section (CS) rate is rising internationally and is associated with increasing maternal and neonatal morbidity and mortality. Vaginal birth after caesarean section (VBAC) is a safe and satisfying option for many women in subsequent pregnancies, however, VBAC rates remain low in many countries. Midwife-led models of care have been shown to improve intended and actual VBAC rates and offer an alternative to obstetric-led care. Birth after caesarean section is not discussed in detail during midwifery training. This session will explore the literature available on the options and care available for women who have had a previous CS and will allow students to discuss their own experiences of caring for women with a previous CS and consider how this care could be improved.
Speaker: Suzanne Wertman
Facilitator: Elisa Segoni
Suzanne will present a motivating discussion of why and how midwives should be engaged as leaders in advocacy and policy making at all levels. We advocate for our patients every day in clinics, hospitals, birth centers and homes. Some of us get involved in political advocacy and policy making at the department, health system, local community levels. Many of us are intimidated or discouraged about making the midwifery perspective on sexual and reproductive health heard at the state, national and global levels, or we don’t see ourselves as advocacy leaders. Find out why each one of us needs to advocate and why it is essential that every midwife has a role in policy making. Learn effective ways that each one of us can increase access to midwifery care, achieve reproductive justice, improve working conditions of midwives, and raise our visibility and status in our communities.
Facilitator: Jane Houston
Background: The aims of this research project are to explore improving timely uptake of antenatal care in the UK.
Data analysis was undertaken, looking at hospital data in an area with high levels of socio-economic deprivation and ethnic diversity. A systematic literature review examined the evidence surrounding ethnic minority women’s experiences of accessing antenatal care in high income European countries. A co-produced intervention was developed, aiming to increase uptake of antenatal care.
Discussion: Of all ethnic groups, Black African and Black Caribbean women had the highest proportion of women booking late. Structural factors impact access to antenatal care for ethnic minority women in high-income European countries. Multiple methods of co-production enabled a diversity of service users to develop a community-level intervention to increase uptake of antenatal care.
Conclusions: There is a need to develop interventions to increase timely initiation of antenatal care.
Facilitator: Paloma Terra
Este painel de discussão reflete sobre a busca pela obstetrícia decolonial, ou seja, uma prática de atenção obstétrica e/ou obstetrícia, que se alinha com a diversidade, interseccionalidade e o reconhecimento das diferentes matrizes que compõem a cultura brasileira, especialmente a afrodiaspórica e heranças indígenas. Os reflexos da colonialidade são persistentes na sociedade brasileira, implicando racismo estrutural, força patriarcal e heteronormatividade, entre outras formas de exclusão, e esses determinantes sociais da saúde ainda são reforçados em um contexto político retrógrado. Assim, propomos trazer para este círculo experiências e saberes que nos desafiem a ir além dos modelos hegemônicos, em direção a múltiplos contextos de obstetrícia, especialmente: experiências com parteiras tradicionais, a busca de memórias de parteiras em contexto urbano e relatos de uso da Ayahuasca durante a gravidez e o parto. Por fim, refletiremos sobre a integração desses saberes na formação acadêmica na área de obstetrícia.
English: Experiences and knowledge in search of a Decolonial Midwifery: Principles, memories. Rural and urban quilombolas and use of Ayahuasca
This discussion panel reflects on the search for decolonial midwifery, that is, a practice of obstetric care and/or midwifery, which is aligned with diversity, intersectionality and the recognition of the different matrices that make up the Brazilian culture, especially the Afro-diasporic and indigenous legacies. The reflexes of coloniality are persistent in Brazilian society, implying structural racism, patriarchal force and heteronormativity, among other forms of exclusion, and these social determinants of health are still reinforced in a retrograde political context. Thus, we propose to bring to this circle experiences and knowledge that challenge us to go beyond the hegemonic models, towards multiple contexts of midwifery, especially: experiences with traditional midwives, the search for memories of midwives in an urban context and reports of the use of Ayahuasca during pregnancy and childbirth. Finally, we will reflect on the integration of this knowledge into academic training in the midwifery field.
O projeto que ocorreu na Chapada Diamantina, na Bahia teve um mini documentário como produção final, pode ser visto no link: https://www.youtube.com/watch?v=JycBeF4JO_M
Speaker: Marie Buckleygray
Facilitator: Stella Katuku
This presentation will describe the importance and value of human connection in Midwifery from the perspective of a student midwife. It will briefly cover the relevant theory and then apply it to examples. The examples will give different perspectives drawing from anonymised practice and continuity of carer caseloads within the new Midwifery course. The presentation will also draw from examples of building student body community during times of potential disconnection in the epidemic lockdowns and moving forward. This presentation will discuss the changes experienced by midwifery students and how these changes could potentially impact our profession and maternity services in the long term.
Facilitator: Cecilia Jevitt
The aim of this presentation is to disseminate the research findings of nursing students’ interactive clinical labor experience with implementing non-invasive pain management techniques: Closing the theory to practice gap. The purpose of this research study was to explore how providing instruction in a didactic simulated scenario using nonpharmacological labor support measures would impact nursing students’ engagement in the clinical setting. The interventions include didactic content within a classroom setting, demonstration and return demonstration by students in a simulated lab experience. It is anticipated that the student would initiate and support the laboring woman within the clinical setting. Teaching the students nonpharmacological methods would address the theory to practice gap that exists. The investigators discuss nursing students’ encouragement and involvement strategies with assisting nurses and nurse midwives during labor support using nonpharmacological measures. Students can assist providers, in particular midwives, with promoting physiological birth utilizing nonpharmacological methods. The investigators will share student perspectives of their involvement with providing labor support.
Facilitator: Paola Wilkin
In this presentation, we will talk about how abortion should be another service midwives can provide everywhere because it is basic healthcare as about 56 million women worldwide have an abortion per year.
Midwives are the ideal care providers for these women because we give one on one care, we prioritize a low-intervention model, women feel safer and better served and midwives also give respectful care as opposed to violent care many women face in the medical industral complex when they get an abortion.
We will argue that abortion care with midwives is also an issue of reproductive justice because it is not only about access to care but also access to respectful, trauma informed, understandable and affordable care and the Midwifery model of care offers all that, care can be given in a home like setting and women´s experience is more positive.
Title: Change leadership in women’s health: Leading with impact
Keynote Speaker: Amber Price
Facilitator: Olajumoke Ojeleye
Be sure to join the VIDM team for the Closing Ceremony after the Keynote Speaker. No need to change rooms – stay here in Room D – 24.
Singer: Isadora Canto
Join the VIDM Organizing team for the closing session with music by Brazilian singer – Isadora Canto, including the premiere of her latest song “Oração Canção do Bom Parto / Good Birth Prayer Song”. She will also perform: “Reconhecimento / Recognition”, and “Plantadeira / Planter”. Follow Isadora on Istagram: @isadoracanto.oficial
We’ll share laughter and tears as we say good-bye for another year, and watch the ‘selfie slideshow’ that has been assembled during the conference.
Closing selfie slide show (Final cut): https://youtu.be/Q3AaCmPxS1Q