Onwards and upwards. Turning a pandemic into midwifery opportunities
Speaker: Sarah Stewart
Facilitator: Deborah Davis
Fifteen years ago I started the Virtual International Day of the Midwife (VIDM) on my kitchen table. The first year I pretty much spent talking to myself. Who could have guessed all these years later that a global pandemic, which would cause such devastation, would also make virtual conferencing an everyday occurrence. And that the organising committee could leverage COVID-19 into an opportunity to grow the VIDM to an audience of thousands across the world. In this presentation I will be reflecting on the lessons I learned over the years I was facilitating the VIDM about leadership, collaboration and innovation which are critical elements we need to influence and shape midwifery and women/people-centred care as we transition out of the pandemic.
Recording: https://youtu.be/TeuD1XwAEU0
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: Paloma Terra and Maria do Perpétuo Socorro da Silva Rodrigues
Facilitator: Susana Ku
This presentation will be based on the research project Midwives of the Brazilian Amazon by Paloma Terra funded by Huron University of Canada. The project uses Critical and Decolonial research methodology and did interviews with Traditional Midwives of the Brazilian upper Amazon Region. This discussion will be a joint presentation in Portuguese with Maria do Socorro who is the president of the Midwifery Association Algodão Roxo a Traditional Midwives Association of the State of Amazonas. We will discuss the place of Traditional Midwifery in the modern world and why it is important to work to preserve and strengthen it. Socorro will present in Portuguese the history of the formation of the Association and their current work and struggles. Paloma will share some of the main take aways from the research project in both English and Portuguese.
Recording: https://youtu.be/RQco_ouNrCU
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: 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
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
Speaker: Linda Deys
Facilitator: Liz McNeill
Abstract:
The problem: Obstetric violence creates visions of a brutal and purposeful assault, however more covert practices cause similar psychological harm, are less understood, and more likely to be disregarded. Separating women from their well-baby at a caesarean section birth can cause long-lasting trauma. Method: A feminist phenomenological study, using birthing theories to understand the experience of women separated from their baby at caesarean section birth without a medical indication. Results: We identified four main themes that were interlinked: Disconnection, Emotional Turmoil, Insight and Influence. This presentation expands on Influence and the sub-themes of power & control, maternal choice & consent, coercion and staff actions. While obstetric violence was perceived with the physically forceful actions that some of these women experienced, it also showed more insidious events which caused comparable traumatic responses. The term ‘obstetric neglect’ was coined to symbolise maternity care where maternal choice and consent was voided by health care providers using power, control and coercion that influenced participant birth outcomes and experience. Conclusion: Birthing in an operating theatre environment limited the capacity of the participants to bodily autonomy and this vulnerability was not accounted for with woman-centred care. Midwifery training and values align with the need for the protection of, and advocacy for, women. These findings demonstrate the importance of a respectful, empowering and supportive midwifery contribution through every pregnancy and birth, in the development of policies and procedures, done in partnership with women.
Recording: https://youtu.be/bCUeuCB2cLU
