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: Elisabeth (Lizi) Jones

Facilitator: Caitlin Goodwin

Indigenous peoples and others living in Alaska and the circumpolar north are geographically remote and face climate conditions that can be extreme. They live in close connection to their environment and have developed characteristics of hardiness and resilience in the face of global pressures such as climate change and colonialism. Long-standing cultural traditions influence birth practices and expectations and are valuable to maintaining a shared sense of connection and caring for one another in these remote communities. Temporary relocation for childbirth has deleterious social effects and there is considerable support for traditional communal birthing in combination with modern techniques and technology. This presentation will describe a selection of Alaska Native and circumpolar childbirth traditions and outcomes, as well as the importance of birth in cultural continuity. Consideration will be given to the preservation of traditions and reflection on one’s own cultural humility and sensitivity, the value of incorporating ancient ways of knowing into modern medical practice, and the importance of promoting sovereignty and reclamation of birth by indigenous midwives worldwide. This presentation draws from a student assignment called “Celebrating Diversity in Childbirth” and is the 8th Annual Georgetown University Midwifery Student Café at the VIDM.

Recording: https://youtu.be/F6hXGnr4pP4

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

Title: Professional Midwifery: Revolutionising Maternal Care in India

Speaker: Indie Kaur

Facilitators: Red Miller and Suman Lata

Research shows that midwife-led care reduces unnecessary interventions, and mothers go on to have better birth experiences. In 2011, Fernandez Hospital piloted an in-house professional midwifery education and training program when such a cadre did not exist in India. Unnecessary interventions like episiotomies and epidurals decreased, and women’s positive feedback increased yearly. Looking at this success, the Government of Telangana and UNICEF partnered with Fernandez Hospital to pilot midwifery training in its public hospitals.

These midwives created a paradigm shift in maternity care, helped increase normal births, and promoted respectful maternity care in the state’s public facilities. This led to the government investing in the need for separate training for midwives in India and launching ‘Guidelines on Midwifery Services’ in 2018. This was a historic moment for midwifery in the country, recognising the need for a separate professional training building on a strong cadre and rolling our midwifery care to women and new-born in the country.

The Foundation has since partnered with The Government of India and Telangana State with the support of The World Health Organisation (WHO) and UNICEF to train midwifery educators in India, strengthening midwifery services.

Recording: https://youtu.be/m-SDNI7B7dA

Speaker: Nurul Hidayah 

Facilitator: Gita Nirmala Sari and Mahanutabah Hamba Qurniatillah

Latar Belakang: Kehamilan remaja merupakan kehamilan yang terjadi pada usia remaja kurang dari 20 tahun. Depresi postpartumadalah suatu kondisi depresi berat yang terjadi dalam 4-6 minggu setelah melahirkan. Tujuan: Menggali bukti ilmiah kebidanan terkait kejadian depresi postpartum pada ibu remaja. Desain: scoping review menggunakan ceklist PRISMA-ScR Metode: Penulis menggunakan kerangka Arksey dan O’Malley. Pencarian artikel menggunakan tiga databased PubMed, Proquest, Science Direct yang mencakup dari Januari 2012 sampai 2022. Alat penilaian digunakan. Seleksi review dan karakterisasi dilakukan dengan penilaian critical appraisal menggunakan studi Joanna Briggs Institude (JBI) tool. Hasil: Dari 809 artikel yang berpotensi relevan, 7 artikel dimasukan. Artikel penelitian tersebut berasal dari 5 Negara yang berbeda, dan metode RCT, Cross sectional dan kualitatif. Hasilnya disajikan dalam tiga tema : Prevalensi depresi postpartum pada ibu remaja, faktor resiko depresi postpartum pada ibu remaja dan pelaksanaan layanan kesehatan dan hambatan dalam menangani depresi postpartum pada ibu remaja.

Kesimpulan: Berdasarkan 7 artikel yang dilakukan review, ditemukan bahwa bahwa 32% ibu remaja memiliki kemungkinan depresi postpartum yang memerlukan tindakan segera pada penilaian awal, deteksi dan intervensi. Faktor-faktor yang berkontribusi terhadap perkembangan depresi postpartum pada ibu remaja termasuk dukungan sosial yang tinggi, masalah perkawinan, tekanan dari orang tua dan masalah ekonomi. Asuhan kebidanan berkesinambungan, strategi dan tindakan pencegahan yang tepat termasuk skrining secara berkala untuk ibu remaja dan penyedia layanan mental diperlukan untuk mengurangi resiko depresi postpartum pada ibu remaja.

English: 

Background: Teenage pregnancy is a pregnancy that occurs in adolescents less than 20 years old. Postpartum depression is a condition of major depression that occurs within 4-6 weeks after delivery. Objective: Explore obstetric scientific evidence related to the incidence of postpartum depression in adolescent mothers.

Design: scoping reviews using PRISMA-ScR checklist Method: The author uses the Arksey and O’Malley frameworks. The article search uses three databases PubMed, Proquest, Science Direct covering from January 2012 to 2022. Assessment tools are used. Review selection and characterization were carried out by critical appraisal assessment using the Joanna Briggs Institude (JBI) tool.Result: Of the 809 potentially relevant articles, 7 were entered. The research articles are from 5 different Countries, and RCT, Cross sectional and qualitative methods. The results are presented in three themes: The prevalence of postpartum depression in adolescent mothers, risk factors for postpartum depression in adolescent mothers and the implementation of health services and obstacles in dealing with postpartum depression in adolescent mothers.

Conclusion: Based on 7 articles reviewed, it was found that 32% of adolescent mothers have a chance of postpartum depression that requires immediate action on initial assessment, detection and intervention. Factors contributing to the development of postpartum depression in adolescent mothers include high social support, marital problems, pressure from parents and economic problems. Ongoing obstetric care, appropriate strategies and precautions including periodic screening for adolescent mothers and mental care providers are needed to reduce the risk of postpartum depression in adolescent mothers.

Recording: https://youtu.be/x2ko_70X4qY

Speaker: Yasmin Rose

Facilitator: Caroline Cherotich Bii

This lecture will walk through the journey of the cord blood from the moment a baby is born, what purpose it serves and why it is paramount babies receive the full amount of blood. The cord blood not only increases the volume of the blood, but is instrumental in setting up the lungs properly. We will look at the difference between fetus circulation and newborn circulation, the difference between waterborn babies and land born babies, and understand why 1 minute cord-clamping is not sufficient. The aim is to achieve optimal cord clamping for every birth.

Recording: https://youtu.be/wVhJ9z3UEsA

Speaker: Ponsiano Kabakyenga Nuwagaba 

Facilitator: Hayat Gommaa

In low- and middle-income countries, several barriers impede utilisation of antenatal care (ANC) services by women with disabilities, yet ANC is a critical entry point for pregnant women to receive quality maternity care services. We investigated the experiences of pregnant women with physical disabilities in utilising ANC services to suggest strategies for improving the services. 

Methods: A qualitative study using a multiple case study design was conducted. Twelve women with physical disabilities and six midwives from three health facilities in Sheema District in rural south-western Uganda, were selected as study participants. Women were sampled using snowball sampling. Midwives and health facilities were sampled using purposive sampling. Data was gathered through face-to-face interviews and a focus group discussion between November 2020 to January 2021. Data was transcribed, translated and thematically analysed. Ethical approval was obtained from University of Cape Town and Uganda National Council for Science and Technology. No competing interests declared. 

Results: Women had mixed experiences of midwives and other health workers, noting that sometimes midwives would be supportive and other times, they would be unapproachable. Participants felt that midwives had limited knowledge on disability and were emotionally unprepared to attend to pregnant women with disabilities. There were suggestions for disability inclusion, including a dedicated ANC clinic and making connections with stakeholders, for fit-for-purpose ANC services. 

Conclusion: Midwives have limited understanding of the implications of physical disability on women’s utilisation of ANC services. Respect for women with disabilities’ dignity and needs should be emphasized in midwifery education and training. 

Recording: youtube.com/watch?v=ihQOrbHdI2M

Speaker: Tom McEwan and Moira Lewitt

Facilitator: Adetoro Adegoke

Respectful of ‘artistry’ within midwifery, a recent research study conducted with Professor Moira Lewitt explored how midwifery students understand the concept of professionalism and how their professional identity develops during midwifery education.  Midwifery students learn and adopt complex professional behaviours in a variety of academic and clinical settings throughout their educational journey. The aims of this study were to explore how midwifery students understand the concept of professionalism and how their professional identity develops during midwifery education.. The method used a conversation about professionalism with a group of final year midwifery students that was transcribed ‘in the moment’ and immediately performed to the group as poetry. Themes emerging from analysis of the conversation are also presented as poetry.  The results demonstrated that midwifery students, moving between university and practice, emphasise the importance of close connections between these spaces and the role models in them, for learning. External constraints generated a sense of fear and stress that was seen to limit midwives’ ability to properly support the needs of ‘their woman’.  We concluded that the notion of ‘spaces’ is important in maternity care and developing education for future midwives. Poetry is a useful multidimensional tool in research.  This utilised poetry as an innovative multidimensional tool for research.  The process of conducting this research, the key themes identified and the poetry generated will be discussed in this session.

Recording: https://youtu.be/nglnqbG26vs

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: Amy Goh, Dia Kapoor, and Anna Nguyen

Facilitator: Olajumoke Ojeleye

Asians and Asian Americans (Asians) have the second highest rate of caesarean birth in the U.S. Asians have the lowest rate of out-of-hospital birth and are low utilizers of midwifery care. This presentation examines cesarean birth amongst Asians who have birthed at U.S. institutions participating in the AABC’s Perinatal Data Registry (PDR). 

Methods: Data from the PDR from 2007-2020 was utilized. Logistical regression was completed to determine the odds of cesarean birth for nulliparous and multiparous Asians in medically low-risk and elective hospitals categories.

Results: 2,983 Asian birthing people were sampled. Multiparous birthing people had 1.5 greater odds of caesarean birth compared to nulliparous birthing people (OR = 1.54; 95% CI, 1.19 – 2.03; p .01). The elective hospitalization group had higher adjusted odds of caesarean births compared to the low-risk and total population (OR = 1.54; 95% CI, 1.23 -1.93; p; .01). Nulliparous people in the elective hospitalization category had a rate of caesarean birth 1.5 times higher than the total (OR = 1.26; 95% CI, 1.09 -1.46; p .01) and 1.36 times higher than the low-risk sample (OR = 1.36; 95% CI, 1.13 -1.63; p .01). 

Conclusion: This study highlights inequities in multiparous and nulliparous cesarean birth among medically low-risk Asians. Further research is needed in disaggregation of perinatal outcomes and on reasons for low utilization of midwifery care and out-of-hospital births amongst U.S. Asians.

Recording: https://youtu.be/jc1ZxhkUvrc