Title: Arte de la Partería Indígena: Resistencias, desafíos y continuidades
Speaker: Tania Pariona Tarqui
Facilitator: Paloma Terra
Los objetivos de este mapeo son: identificar organizaciones de parteras indígenas, además de delinear la situación en la que se encuentran y las experiencias que se han generado cada país, acorde a su contexto histórico y aspectos legales. Finalmente, indicar las buenas prácticas, recomendaciones y retos señalados por las organizaciones de parteras de cada país.
Uno de los elementos relevantes del mapeo, es las diferencias que existen entre el ejercicio de la partería y la relación con el Estado, esto de acuerdo al nivel organizativo alcanzado por los grupos de parteras y los avances legales en el reconocimiento de la misma. Por ejemplo, algunas parteras en sus países presentan un estado de sobrevivencia por el poco o nulo reconocimiento de los pueblos originarios y la partería indígena, en otros casos por su nivel de organización hay parteras indígenas que en sus países exigen autonomía al Estado.
Sin embargo, en todos los países se dan prácticas de control, desprestigio y criminalización. Esto realza la importancia de fortalecer las organizaciones de parteras y de los pueblos originarios para la construcción de propuestas desde los sistemas de salud indígenas y la articulación horizontal con los Estados.
Como parte de sus recomendaciones se destaca la necesidad de fortalecer el tejido organizativo entre las parteras tanto a nivel nacional como en la región, el politizar la lucha por el respeto a las parteras y todas las mujeres como sujetos de derechos para que puedan tomar decisiones informadas sobre su cuerpo, su maternidad y la atención del parto desde su propia tradición y la necesidad del cuidado de las abuelas parteras que viven en situaciones vulnerables como garante de la continuidad generacional para el cuidado de las mujeres y comunidades de los pueblos indígenas.
Recording: https://youtu.be/zuIlj3va4E4
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: 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: 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: Erin Hanlon
Facilitator: Cecilia Jevitt and Akusmayra Ambarwati(Shadow)
Abstract:
Since 1990, New Zealand midwives have been privileged to elect to work within tertiary or primary health settings, employed, self-employed (case-loading), or a hybrid variation of both. However, despite the availability of midwife-led care, the local home birth rate has not substantially increased nor have medical interventions decreased, despite having a continuity of care. Narrative Inquiry methodology and methods were used to investigate the changes in the birthing culture in New Zealand from 1990 to today. The elements of temporality (time), sociality (social context), and place were borrowed from Connelly and Clandinin (2006) to collect and analyze stories from midwives and consumer participants nationally. This presentation initially maps the history of midwives gaining autonomy in New Zealand, then explores the experiences of midwives who spoke about a transition in their clinical practice from working within a highly medicalised model across the spectrum to attend home births. These hospital-trained midwives’ shared their stories of how performing highly technological services in labour instilled fears around birth. Participants discussed that in order to become home birth midwives, they needed to unlearn and then relearn the skills required to attend women birthing at home. Using temporality and sociality contextualized their accounts, as participants shared their experiences of how they discovered what birth ‘could be’ with less interference, which separated them apart from the dominant medicalised culture surrounding birth. As they relayed their stories around their relearning, they expressed a collegiality with other practitioners, and supportive, trusted relationships with women.
Recording: https://youtu.be/cG21rLXEzmo
Speaker: Divya Raghavan
Facilitator(s): Rizka Ayu Setyani & Mutiari Safitri(shadow)
Abstract:
Midwives play a pivotal role in providing comprehensive support to women navigating the challenges of recurrent pregnancy loss (RPL). This abstract outlines key aspects of midwife support in this context. Emotional support is fundamental, with midwives fostering open communication and offering empathetic counseling to address the emotional toll of RPL. Education and information dissemination involve explaining medical procedures, test results, and providing insights into lifestyle factors affecting pregnancy. Care coordination is crucial, emphasizing collaboration with healthcare professionals to ensure well-rounded, personalized care. Midwives engage in proactive preconception care, assessing health factors and developing tailored plans for subsequent pregnancies. Support groups, facilitated by midwives, create spaces for women to share experiences and access community resources. Advocacy is integral, empowering women to actively participate in their care and collaborating with healthcare providers for comprehensive support. Continuity of care is established through building strong relationships, fostering trust, and providing ongoing support throughout the reproductive journey. Taking a holistic approach, midwives address both physical and emotional needs, recognizing the interconnected nature of well-being. Ultimately, by embracing these multifaceted roles, midwives contribute significantly to enhancing the overall care and resilience of women facing recurrent pregnancy loss.
Recording: https://youtu.be/7Gn5Xt0T4sE
