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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.
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…
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: 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.
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.
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: 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
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.
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.
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.
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: 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: 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
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.