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
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: Alison Eddy and Carol Bartle
Facilitator(s): Catherine Salam (Izza Alifina)
Abstract:
Te Kāreti O Nga Kaiwhakawhanau Ki Aotearoa | The NZ College of Midwives and their college members are promoting midwifery action on climate change and working towards supporting national and global initiatives which reduce the negative impacts of climate change. Wherever they work midwives can consider the environment and identify ways to minimise their impact both personally and professionally. Small actions can grow into a significant movement and midwives can advocate for social change in relation to sustainability and healthy environments. The ‘fingerprint of climate change’ has been described as beginning before a baby is born due to pregnant women already enduring environmental crises that their children will be exposed to after birth.[1] This presentation tracks how an increased awareness of the impact of climate change sparked the College into action aimed at supporting some mitigation of climate change via a lens on midwifery practice related to pregnancy, birth, and infant feeding. The College recognises the potential for midwifery globally to develop a model of excellence for climate action and sustainability and we will present what we have achieved so far, and the steps we are taking towards collective action.
[1] Pacheco, S. (2020). Catastrophic effects of climate change on children’s health start before birth. The Journal of Clinical Investigation, 130(2),562-564.
Recording: https://youtu.be/LRidySKzuBU
Speakers: Fabella Elisa Cahyaningtyas and Zalfa Dinah
Facilitator: Caroline Maringa
Abstract:
Background: The increase in cesarean sections has occurred throughout the world, especially in developing and developed countries, over the last few decades and has led to increased research, debate, and concern among health professionals, governments, policymakers, scientists, and clinicians. So, to overcome the increasing number of cesarean sections, the VBAC technique was developed, namely vaginal birth for pregnant women who have had a history of cesarean sections in previous pregnancies. 90% of women who have a cesarean section are possible candidates for VBAC during a subsequent pregnancy. 60%–80% of them are able to give birth successfully vaginally. Mentoring is defined as the process of providing convenience to clients in identifying needs and solving problems, as well as encouraging the growth of initiative in the decision-making process, in this case, the decision to choose VBAC. So this study article aims to describe assistance for a successful VBAC. Case Report: Assistance for a 36-year-old pregnant woman with G4P2013 since 25/26 weeks of gestation at one of the PUSKESMAS in Surabaya. BSC 2x: history of a happy pregnancy in the first pregnancy and history of curettage abortion in the second pregnancy. The last child is 2 years old. Have the desire to give birth naturally. Mother had a successful VBAC without tearing on 7/7/2022 at 39/40 weeks of gestation. Conclusion: Assistance provided to pregnant women is a strategy that really determines the success of the maternal and neonatal health empowerment program in making birth decisions using the VBAC technique
Recording: https://youtu.be/953OjyMpdtc
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
Speaker: Arafin Happy Mim
Facilitators:Raissa Manika Purwaningtias & Constance Odonkor(shadow)
Abstract:
I am Mim, a Young Midwife Leader from Bangladesh. One year ago, I assumed the role of supervisor of midwives on Basanchar, a remote island near Hatiya Upazilla, Bangladesh, catering to 32,574 people and 7899 families, many of whom were Rohingya refugees relocated from Coxs Bazar. The island faces numerous health challenges, especially for women and children, with limited access to medical facilities, requiring Navy Frigate transportation twice weekly. Upon arrival, I encountered midwives lacking confidence and support in their practice. As the first midwife supervisor, doubts surrounded my leadership abilities, compounded by the democratic system’s challenges. Despite skepticism, I prioritized listening, reflection, and evidence-based advocacy to empower midwives and amplify their voices. Through collaborative efforts, we transformed the team, nurturing leadership skills and expanding their scope of practice. With a multidisciplinary approach, we now offer comprehensive sexual and reproductive health services and manage most complications locally, minimizing the need for external transfers. Looking ahead, our focus is on community awareness, affirming the pivotal role of midwives, and ensuring their practice aligns with standards. Continued education and research will further enhance our contributions to midwifery in Bangladesh, fostering a culture of quality care and acceptance in Basanchar.
Recording: https://youtu.be/_PO0Pisbxww
Speakers: Rowsan Ara, Joy Kemp and Nabila Purno
Facilitator: Linda Wylie
Abstract:
Bangladesh is one of the most climate-change affected countries. Regular natural disasters, extreme heat, air-pollution and outbreaks of vector-borne diseases put thousands of pregnant women at risk, particularly in hard-to-reach locations with limited access to healthcare services. Midwives play a crucial role in addressing these challenges; they are often the first point-of-contact for women in the healthcare settings and can orient women about birth preparedness, disaster preparedness and in general protecting their health from known environmental and climate risks. The Government of Bangladesh has a workforce of 7,230 midwives. In 2023, a training manual on the Climate-Change Impacts on Sexual and Reproductive Health in Bangladesh was developed by CCHPU and UNFPA then reviewed with national experts. Existing curriculum review found commendable inclusion of gender equality, reproductive health and rights, and disaster management but weak content on the intersection between climate change and health. A three-day Training of Trainers (ToT) program was thus developed, targeting 20 Nursing and Midwifery faculty, serving as a catalyst to disseminate essential knowledge and equip educators with the tools to integrate climate change perspectives into their teaching methodologies. A series of cascade training ensued, with a day-long training for final-year Midwifery students and a specialized session for 50 practicing midwives across various health facilities. These efforts underscore the government’s commitment to ensuring a health-workforce well-versed in addressing climate-change impacts, particularly concerning sexual and reproductive health. This content must now be integrated into nursing and midwifery curricula across all education levels.
