VIDM 2023 Programme

Facilitator: Jane Houston 

Join us at this pre-conference event with colleagues from the World Health Organization (WHO) celebrating the worldwide contribution of midwives.

Welcome and introduction from the World Health Organization (WHO) by Frida Berg with video greetings from 

• Chief Nursing Officer:  Dr Amelia Latu Afuhaamango Tuipulotu
• Director General: Dr Tedros Ghebreyesus

We will then explore the following topics: 

1. Evidence to reality in 6 countries, strategic findings  (Clara Fischer and Prof. Lorena Binfa)  
2. Evidence to reality – From STAGE – recommendations on midwifery and how to take this forward  (Justine Le Lez)
3. Essential Childbirth care course and the Interprofessional Midwifery Education Toolkit  (Dr Florence West and Indie Kaur)
4. What’s new in WHO? (Dr Emily McWhirter)

Following a Question and Answer period, Dr Anshu Banerjee will provide closing remarks from WHO. 

Recording: https://www.youtube.com/watch?v=6OAqCOOGfz0

Speaker: Paola Wilkin, Jane Houston, Megan Arbour 

Facilitator: Paloma Terra

Postpartum Haemorrhage (PPH) remains one of Peru’s leading causes of maternal morbidity and mortality, with nearly 20% of maternal deaths caused by PPH in 2019. Early recognition of PPH and prompt treatment remains challenging in low-resource obstetric settings, including among Mestizo midwives in Peru.  Midwives and obstetricians may experience barriers to the timely diagnosis and management of PPH including access to quantitative blood loss measurement methods, and timely haemoglobin blood laboratory tests. In addition, formalized PPH diagnosis and management training may not be available.

PURPOSE/AIM: The purpose of this quality improvement initiative is to increase the accuracy of postpartum blood loss measurement by Mestizo Peruvian midwives through hybrid educational sessions.  

Methods: 3 international midwives collaborated to develop this quality improvement project. Clinically practicing midwives, midwifery interns, and midwifery students were recruited from the 2 main public hospitals in Arequipa, Peru to participate in a web-based training module, and subsequent live skills demonstration regarding how to quantitatively assess postpartum blood loss.  The primary author is a Mestizo Peruvian dentist and midwife, and all materials were developed in a linguistically and culturally safe manner.

After the web-based training module, participants were surveyed on their level of comfort and self-efficacy with quantitative blood loss measurement using google forms, distributed via WhatsApp. 

This quality improvement initiative was deemed exempt by the Frontier Nursing University IRB.

Results: Preliminary results and the next steps will be available and shared during the presentation.

Recording: https://youtu.be/UTrVPckPWUY

Speaker: Susana Ku  

Facilitator: Paola Wilkin

We are a growing transnational collective consisting of members from the Global South and North, including midwives, doulas, scholars, educators, and mothers calling for an expansion of midwifery research to include what we coin “Critical Midwifery Studies”. We envision a Critical Midwifery Studies that uses three principles: 1.engagement and collaboration with rapidly developing fields within critical theory, 2.midwifery-led, 3. self-critical (developing ways to implement critical theory into practice). Systemic injustice is a threat to sexual, reproductive, maternal, and newborn health, hence the application of the art and science of midwifery. The effects of this injustice are reflected in the high maternal and neonatal morbidity and mortality rates in formerly colonized countries of the Global South, in marginalized communities of the Global North, and in underprivileged classes around the world. We aim for an open discussion about midwifery research, education, practice, policy, and regulations, that are largely White and Western-centric, using positivistic and universalist principles of biomedical research. Although we recognize the global struggle for legitimacy that midwives face as they work to make their models of care more accessible, this coincides with pressure to engage with dominant and dominating paradigms, using language and approaches that are valued by regimes of power.

Our presentation will include a summary of our experience launching the first bilingual summer school for Critical Midwifery Studies held on July 2022, with delegates around the world. We will explain how our collective planned this activity including principles of equity and accessibility https://tinyurl.com/yc55dbw6.

Recording: https://youtu.be/TKrSfdmC9nM

Speaker: Fatimah Siti and Andari Wari Astudi

Facilitator: Belle Bruce

Marriage and pregnancy in adolescence affect the health, financial and educational status of adolescents. Pregnancy in adolescence also creates stigma and negative issues in society and families. This Scoping review aims to find out the latest evidence based on the experience of adolescents who early marriage in decision making during pregnancy and childbirth. 

The method used in this scoping review refers to the framework of Arkshey and O’malley and is documented into the PRISMA Flow Chart. Research article search strategies used include using inclusion and exclusion criteria, using MeSH (medical subject heading), truncation and boolean operators. The databases used include Pubmed, Sciencedirect, Proquest, EBSCO, and Wiley Online Library and also use grey Literature such as Google Scholar. 

From 2,134 articles, the initial search found 9 articles that are eligible for a thorough review and resulted in 4 main themes, namely the decision-making process during pregnancy and childbirth, factors affecting decision-making during pregnancy and childbirth, forms of support in decision-making and expectations in decision-making during pregnancy and childbirth. 

From the review of articles conducted, it is known that most teenagers lose autonomy in decision making because it is often done by older family members and is considered more experienced. The existence of programs and/ education related to adolescent health using gender and cultural approaches is expected to increase participation and  role in decision making.

Recording: https://youtu.be/cmj5HN8i_ss

Speaker: Tsegaw Biyazin

Facilitator: Caroline Maringa and Meron Tessema Bekele

Antenatal fetal surveillance is a method of monitoring fetal welling during intrauterine life. Fetal movement counting is one parameter of antenatal fetal surveillance and it has a vital role to reduce stillbirth and prenatal mortality. This study aimed to assess maternal knowledge of fetal movement among pregnant women in Jimma Medical center, Jimma, Ethiopia.

Method: A facility-based cross-sectional study was conducted at Jimma Medical center from June 1 to July 30, 2022. A structured and pretest questionnaire was used to collect data. A systematic sampling technique was applied to collect data through a face-to-face interview. Binary and multivariate logistic regression was carryout to identify candidate predictors and significant variables respectively.

Result: A total of 422 respondents involved in the study. The majority of respondents 189(46.7%) were in the age group of 25-31 years. Regarding marital status, more than three-fourths of 323(79.8%) participants were engaged. Only one hundred twenty-two (30.1%) of respondents had good knowledge regards to their fetal movement count. predictors includes residence [AOR=.29, 95% CI (.16-.56), P value;.000], gestational age [AOR=.42, 95% CI (.24-.76);P-value;.004], high-risk pregnancy [AOR=5.34, 95% CI (2.46-11.60); P-value;.000] and health care provider [AOR=2.61,95% CI (1.49-4.56); P-value;.001) were among significant variables with knowledge of fetal movement counting.

Conclusion: the overall maternal knowledge regards fetal movement is unsatisfactory. Respondents’ residence, gestational age, pregnancy status, and source of information were significant predictors of maternal knowledge. Health care providers.

Recording: https://youtu.be/1P-fOkA9tPg

Speaker: Sarah Smits

Facilitator: Liz McNeill

Sharing knowledge and stories to promote the work of The Midwife Project. A project to support the preservation of Mayan midwifery wisdom and bridge the gap between the knowledge of the younger generations of clinically trained midwives and the elder traditional midwives. Honouring and understanding the importance of both the knowledge of modern and traditional midwifery practices to best serve their community. 

Lake Atitlan, Guatemala has a prevalent population of Mayan people still practicing Mayan cosmology and ways of life. 

Due to cultural practices and barriers to accessing the only hospital around the lake, many women birth at home with Mayan midwives. Yet the Mayan midwifes, some of whom have been practicing midwifery for 40 years, report how births are becoming more complicated and welcome the opportunity to learn different skills to support their communities growing needs. 

The Midwife project aim to bridge this gap. A 6 month training program was initiated in 2022 whoch offers the opportunity for the elder midwives to learn clinical skills and for the younger generation of midwives to learn the traditional Mayan practices. 

Every week more and more women, some as young as 12 who have had the calling to become midwives join the project. It is an important opportunity to strengthen the community of Mayan midwives, so they can better support their community. 

Recording: https://youtu.be/mILlyDhuadE

Title: When art and science collide: towards a political philosophy of humanised birth

Speaker: Elizabeth Newnham

Facilitator: Red Miller

In this presentation I draw together the various threads of my work to propose a political philosophy of birth space and practice. I first examine how the ‘science’ (of knowledge production) affects the ‘art’ (of midwifery practice) using the example of epidural analgesia, water immersion and constructions of ‘safety’ in obstetric discourse. From this, I introduce the conceptual framework of the ‘institutional paradox’ – the framing of particular practices as safe or risky, the effects of ‘institutional momentum’, and the precarious positioning of midwives as ‘guardians of normal’ within a system that views birth as, at best, risky, at worst, pathological. I then show how the influence of this institutional paradox leads to a form of rhetorical informed consent that enables dehumanising birth practices, before using the lens of care ethics to turn to the work of humanising birth, with a focus on relationality and the concept of attentiveness.

Recording: https://youtu.be/AshmJUtO7nI

Speaker: Arafin Happy Mim  and Toma Ray 

Facilitator: Margaret Aoro Adongo and Yosef Alemayehu Gebrehiwot

We are two young midwife leaders (23 years old) in Bangladesh who are board members of our midwives’ association (MA) and have recently graduated from an international leadership development programme. One works in a government health centre, the other in a Rohingya refugee camp.  During 2022 we used quality improvement (QI) methodology to help our MA recruit and retain its members, and to develop guidance on responding to various types of emergency situations, which happen frequently in Bangladesh. 

Discussion: MAs are examples of women-led civil-society organisations that can improve gender-equity and access to sexual and reproductive health rights, and act as agents for the profession (Mattison et al 2021). They have potential to impact each element of the ICM’s professional framework for midwifery.  As midwifery is a new profession in Bangladesh, the midwives association (the Bangladesh Midwifery Society) is led by young women who are enthusiastic but inexperienced in organisational governance and leadership. A structured programme that taught us QI methodology was helpful for our leadership development, enabling us to drive change in our workplaces and in our MA. 

Conclusions/Summary: We found it hard to apply QI methods to organisational development but we made it work. By sharing our lessons learned we hope to help other midwives and midwives’ associations understand how they can improve the quality of their services. 

Reference:  Mattison et al (2021) doi:10.1136/bmjgh-2020-004850

Recording: youtu.be/IcuXTEOj7WQ

Speaker: Joy Kemp  and Sharmin Shobnom Joya

Facilitator: Aisha Salihu Abdullahi

A 5-year twinning partnership between the Bangladesh Midwifery Society (BMS) and the Royal College of Midwives UK was completed and evaluated in 2022; results will be shared in this presentation. Twinning was both organisational and individual.  Midwives are new in Bangladesh; they are negotiating professional space. UK midwifery is more established but the workforce is not representative of the population with Bangladesh heritage (1%); maternal and perinatal outcomes are worse for South-Asian families.  Therefore, twinning had potential benefit for both contexts. 

Objective: To evaluate if twinning had mutual benefit, especially in strengthening midwifery leadership.

Methods: A mixed methods enquiry using document-review, surveys, focus-groups, key informant interviews and participant observation.  Evaluation framework informed by OECD criteria and stakeholder questions. Thematic data analysis.

Results:  BMS’ organisational capacity increased significantly during the partnership. Fifty-one young midwife leaders in Bangladesh were developed and six won international leadership fellowships. Seven quality- improvement projects in Bangladesh were successfully completed, advancing midwifery services. UK midwives valued and learned from their participation. The partnership enabled greater engagement with South Asian diaspora midwives in the UK and highlighted inequity of UK maternity outcomes. The COVID-19 pandemic brought both challenges and opportunities for innovation.

Conclusions/Summary: This partnership strengthened midwifery associations and midwifery leadership and impacted every area of the ICM’s Professional Framework in Bangladesh. Twinning facilitated reciprocal benefits in both countries and may be replicable in other contexts.

Recording: https://youtu.be/jCiv_7LqMnA

Speakers: Bhavya Reddy

Facilitator: Heather Brigance and Sabina Ojil

Despite decades of considerable economic investment in improving the health of families and newborns world-wide, aspirations for maternal and newborn health have not been attained in many regions. The global turn toward recognizing the importance of positive birth experiences and reducing adverse outcomes signals a critical change in maternal and newborn health care conversations and research priorities. In this session we will introduce QMNC’s new program, communications platform, and approach designed to facilitate our focus on answering “different research questions,” drawing on evidence presented in the 2014 Lancet Series on Midwifery and a research prioritization study conducted with the World Health Organization from 2016. The objective of this workshop is to orient midwifery researchers, and especially future researchers, as well as those in the global south, to connect, collaborate, and develop capacity in research aimed at improving maternal and newborn health outcomes globally. It is critical that the professions of midwifery and midwifery science develop strong collaborative networks and research capacity aimed at answering critical research questions whose answers can reduce preventable maternal and infant death and suffering. The QMNC Research Alliance has acquired the preliminary funding needed to build a global platform and to hire support staff to facilitate this work. This session will be interactive, guiding attendees to identify where their research interests and expertise aligns with the three priorities. Participants who continue to engage with the QMNC beyond this session will also be invited to publish on the process of working together via the QMNC online platform.

Recording: https://youtu.be/Ut7r1QqyREQ

Speakers: Heather Bradford and Jeremy Neal

Facilitator: Catherine Salam

Healthcare providers’ weight bias has been associated with negative patient interactions and poor quality of care. This dissertation is the first to measure weight bias among midwives and determine if the weight bias scores differ from other health professionals and the U.S. public. A research study was conducted which involved electronically surveying AMCB-certified midwives during the 2022 ACNM Annual Meeting and via email. Preliminary findings reveal that AMCB-certified midwives have a preference for people with underweight or normal body weights. The findings may inform future studies to determine if there is an association between perinatal providers’ weight bias and clinical decision-making, quality of care, and perinatal outcomes such as cesarean birth rates among birthing persons with higher body weights.

Recording: https://youtu.be/L-TScIK_7A0

Speaker: Florence Wilcock 

Facilitator: Ally Anderson and Liticia Arthur

I am fortunate to work in the UK NHS within a midwifery-based system of maternity care where the role of the midwife is well recognised and respected. Despite this maternity care can sometimes break down and become a ‘them and us culture’ with conflict between different staff groups with midwives perhaps seen as advocates for women in contrast to obstetricians using a more paternalistic and medicalised model. I know in other regions in the world this can be even more marked with very obstetric based models and obstetric nurses in some countries or else with limited access to either profession in others. In this talk I will discuss my experiences of working alongside midwifery colleagues to try and enable women centred holistic care as well as making some suggestions of how you might build effective working relationships with obstetric colleagues.

(FRCOG aka TheObsPod)

Recording: https://youtu.be/jx2ANo8ZmnE

Speaker: Brenda Araujo Salas 

Facilitator: Paloma Terra

A partir de las ilustraciones elaboradas por Yaquemilsa Matiashi Vicente, una joven madre del pueblo Matsigenka, perteneciente a la amazonía peruana, describiremos las prácticas tradicionales en salud materna que aún se mantienen vigentes en las comunidades más alejadas de la vida moderna. Se describirán las concepciones y prácticas culturales durante la primera menstruación, los cuidados en el embarazo, la atención del parto por parte de la familia y parteras, y los cuidados en el posparto.

Conocer gráficamente las prácticas en salud materna a través de la mirada de una mujer del mismo pueblo, nos permite visualizar detalles significativos que se dan en la los cuidados de las mujeres gestantes y los recién nacidos. La importancia de este material es educativa y en favor de una mejora en la atención del parto para fundar la comprensión y el respeto a las costumbres y participación de las parteras y especialistas tradicionales de salud, ya que, actualmente, gran parte de las comunidades amazónicas tienen acceso a establecimientos de salud, pero estos ofrecen servicios sin pertinencia cultural. Por otro lado, el material también permite el reconocimiento de la importancia de los conocimientos de las mujeres Matsigenka en los niños, niñas y adolescentes.

English:

From the illustrations elaborated by Yaquemilsa Matiashi Vicente, a young mother of the Matsigenka people, belonging to the Peruvian Amazon, we will describe the traditional practices in maternal health that are still in force in the communities farthest away from modern life. We will describe the cultural conceptions and practices during the first menstruation, pregnancy care, childbirth care by the family and midwives, and postpartum care.

The graphic presentation of maternal health practices through the eyes of a woman from the same village allows us to visualize significant details in the care of pregnant women and newborns. The importance of this material is educational and in favor of an improvement in childbirth care, in order to establish understanding and respect for the customs and participation of midwives and traditional health specialists, since, at present, most Amazonian communities have access to health facilities, but these offer services without cultural relevance. On the other hand, the material also allows the recognition of the importance of Matsigenka women’s knowledge in children and adolescents.

Recording: https://youtu.be/voZyHiTevvw

Speaker: Lucia Monetta

Facilitator: Susana Ku

In 2020, our Argentina Midwifery Association  launched a pilot program to develop a committee to strengthen two areas that have been less explored in our profession: research and leadership.

With the group of 4 young midwives, this committee developed a purpose, objetives and structure that will allow argentinian midwives to develop skills that will equip them to make a visible impact on their communities, by positioning midwifery in the Research Health field and to take on leadership roles in the Health Care Systems and organizations that tackle Sexual, Reproductive, Maternal & Newborn Health injustices and inequities. 

From this initiative, several program were born: internships/mentoring program, educational programs in research studies, conferences, seminars and one of the biggest accomplishments: a registered Midwifery Journal. 

The leadership program has grown over the past three years, achieving important leadership roles, mentoring midwives, as well as, more publishing and research opportunities. 

The Midwifery Journal “OBSTETRIX” continues to grow with more collaborations, more midwives publishing their research work from central, Latin America, and more  than two thousand subscribers. 

In this presentation, we want to encourage midwives to initiate this kind of programs and innovation to develop in their countries. We would like to explore the experiences and opportunities and that can be achieved by working with a unique working environment that allows midwives to develop their full potential and the lessons learned throughout this program. 

Recording: https://youtu.be/vC2DOEfLsLQ

Speaker: Patricia Marianella 

Facilitator: Paloma Terra

El objetivo fue comparar los resultados materno-neonatales y costos de la resolución de embarazos, en mujeres obesas y con peso normal pregestacional.

Métodos: Estudio transversal realizado en 60 gestantes con obesidad y 120 con peso normal pregestacional atendidas en un hospital público de Lima durante el 2018, seleccionadas aleatoriamente. Se recolectaron datos sociodemográficos, indicadores maternos (índice de masa corporal pregestacional, controles prenatales, edad gestacional, días de hospitalización), neonatales (Apgar, peso, morbilidad, edad gestacional por examen físico, días de hospitalización) y datos de los costos (medicamentos, procedimientos e insumos). Se utilizó la prueba estadística U de Mann Whitney.

Resultados: Se encontraron diferencias entre mujeres obesas y con peso normal pregestacional en los días de hospitalización materna (3 ±1,2 días vs 2,0 ±1,2 días; p=0,000); en el peso del recién nacido (3 615 ± 518,03 gr vs 3 245 ± 426,25 gr; p=0,000), en el costo de medicamentos ($ 19,78 ±16,47 vs $ 3,21 ±15,57; p=0,000), en el costo de procedimientos ($ 40,65 ±46,78 vs $ 27,67 ±49,47; p=0,001), y en el costo de insumos ($ 54,08 ±29,02 vs $ 9,32 ±28,26; p=0,000).

Conclusión: Las mujeres obesas presentaron recién nacidos con mayor peso, contaron con más días de hospitalización y los costos de medicamentos, procedimientos e insumos fueron superiores en comparación con las mujeres de peso normal.

English: 

The objective was to compare maternal-neonatal outcomes and costs of pregnancy resolution in obese women and women with normal pregestational weight. Methods: Cross-sectional study conducted in 60 pregnant women, randomly selected, with obesity and 120 with normal pregestational weight attended in a public hospital in Lima during 2018. Sociodemographic data, maternal indicators (pregestational body mass index, prenatal controls, gestational age, days of hospitalization), neonatal (Apgar, weight, morbidity, gestational age by physical examination, days of hospitalization) and cost data (drugs, procedures and supplies) were collected. The Mann Whitney U statistical test was used. Results: Differences were found between obese and pregestational normal weight women in maternal hospitalization days (3 ±1.2 days vs. 2.0 ±1.2 days; p=0.000); in newborn weight (3 615 ± 518.03 gr vs. 3 245 ± 426.25 gr; p=0.000), in the cost of medications ($ 19.78 ±16.47 vs $ 3.21 ±15.57; p=0.000), in the cost of procedures ($ 40.65 ±46.78 vs $ 27.67 ±49.47; p=0.001), and in the cost of supplies ($ 54.08 ±29.02 vs $ 9.32 ±28.26; p=0.000).Conclusion: Obese women had heavier newborns, more days of hospitalization and the costs of medications, procedures and supplies were higher compared to women of normal weight.

Recording: https://youtu.be/McAV7M1Ub4M