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: Wendy Foster
Facilitators: Belle Bruce and Siti Khuzaiyah
Problem: Across the globe midwives are leaving the profession. Moral distress may contribute to this attrition. While moral distress is broadly understood within health care disciplines a contextual understanding of moral distress in midwifery is limited. Current tools available to screen for moral distress are not as suitable for use in midwifery practice.
Methodology: This project is an exploratory sequential mixed methods design that occurred across four phases; concept analysis, in-depth interviews, an e-Delphi study and a pilot study. This presentation will present key findings from the first three phases.
Results: Midwives report feeling demoralised and confirmed the presence of moral distress in practice due to excessive workloads, unnecessary intervention and hierarchical medical systems. Health care organisations are identified as placing midwives in morally compromising situation that are significant factors in the development of moral distress. Negative psychological outcomes are a key feature in moral distress with midwives describing symptoms of work-related stress and anxiety, increased sick/personal leave, feelings of powerlessness and burnout. Importantly it was identified that moral distress was likely to occur across a continuum from low (moral frustration), moderate (moral distress) and severe (moral injury). A pilot tool to screen for moral distress across a continuum has been developed.
Conclusion: Moral distress is a significant issue in midwifery practice. The development of the midwifery moral distress screening tool has enhanced the conceptual understanding. This study has provided additional language for midwives to describe their experiences and may assist organisations to identify and address ethical challenges within workplaces.
Recording https://youtu.be/Czfj3EUg6g4
Speaker: Ang Broadbridge and Rachel McDonald
Facilitator: Raissa Manika Purwaningtias
Abstract:
Abstract summary: Sharing learning from four prototypes in the North East of England where we have developed new maternal mental health supports through collaboration and co-production across sectors, with key indicators of building sustainability Background – Project demonstrates improved maternal mental health through integrating third sector support into the pathway to reduce health inequalities and increase sustainability supporting the best start in life agenda with benefits for women, partners, their babies and the whole family unit in the perinatal period. The MMHS social prescribing link worker model aims to provide evidence based maternal mental health support based in the third sector: • The perinatal period is a time when women have regular contact with services, when there is a crucial window of opportunity to support a best start. • Building and integrating flexible third sector provision with referrals from midwifery, health visiting, mental health and community teams to overcome workforce capacity and waiting list pressures and threshold barriers complementing statutory offers through specialist, personalised non-clinical support Discussion • Project addresses health inequalities, issues for ethically minoritised communities and social determinants of health including sustainability and accessibility in rural and remote communities • Evidences benefits for mum and infant as well as wider family unit • Indicators of sustainability – developing sustainable community support networks, reducing duplication, developing eco-friendly accessible digital resources and supports and increasing digital inclusion Conclusion – Innovative and flexible approaches developed through cross-sector collaboration leading to sustainable practice and initiatives
Recording: https://youtu.be/ZwyvGbl7eNw
Speaker: Ally Anderson
Facilitator(s): Kate Frith
Abstract:
Background: Midwives are the foundation to reducing maternal and neonatal mortality. Midwives facilitate physiological birth processes to support and enable women to have an optimal birth. Maternity care in the Czech Republic is obstetric led, medicalised and patriarchal. The Midwifery Unit Network collaborated with a Czech hospital to provide training for midwives on optimal birth techniques as part of a wider initiative to develop the first midwife-led unit in Prague. Aim: To explore the facilitators and barriers for implementing the learning objectives of a bespoke ‘Optimal Birth’ Programme into practice in a state hospital in Prague, Czech Republic. Method: A qualitative descriptive phenomenological approach was followed. Purposive sampling was used to select nine participants who met the selection criteria, were willing to participate, and signed the consent form. Data collection was via two participation observations and semi-structured interviews. Thematic analysis was carried out on the data retrieved. Results: Six main themes emerged: politics and society, organisational culture, supporting physiology, models of care and technology use, resources to support practice shift and supporting the practice shift. Discussion: Many facilitators and barriers were discussed, ranging from the political and organisational level to the funding and resources available and the confidence of the individual practitioners.
Recording: https://youtu.be/VUdhypSe8B4
Speaker: Margaret Jowitt
Facilitator: Caroline Maringa
Abstract: The uterus is a wonder of bioengineering. If only we could respect its mechanism better, we could encourage more babies to be born into the hands of a midwife, who can then swiftly transfer them into the arms of their mother. Within the space of a few hours, the uterus is transformed from a safe haven, a strong fortress for a vulnerable fetus – into the means of their transition to the outside world. Since the mid twentieth century, birth workers have been given a one dimensional view of uterine activity – that contractions start from the fundus and push downwards. Managing labour using this flawed model has tethered women to the obstetric bed, encouraged overuse of synthetic oxytocin and denied the uterus its full directive power. It’s time to think again. We need to learn to respect the uterus, to respect its owner and to respect its occupant, the baby, who also plays an active part in birth. Fortunately, we can rehumanise childbirth with a far more accurate user-friendly model – The Womb’s a Balloon.
Recording: https://youtu.be/DmRj1vII8qk
Speaker: Tracy Donegan
Facilitator: Portia Khanyile Shanduka
Abstract:
In recent years, the integration of light therapy into healthcare has emerged as a groundbreaking innovation. This novel approach, also known as photobiomodulation (PBM,Red Light Therapy, LLLT) harnesses the therapeutic potential of specific wavelengths of light (Red, Blue and Near Infrared) to accelerate wound healing, reduce the risk of infections and enhance overall well-being for mothers. The benefits of light therapy in postpartum care are multifaceted. PBM has been shown to alleviate acute pain by activating TGF-B1 and TRPV 1 in the cells promoting a more comfortable recovery without medication. The non-invasive, quick acting, harmless nature of light therapy makes it an important option for mothers seeking alternative methods to manage pain without relying solely on pharmaceutical interventions. Light therapy stimulates cellular repair and regeneration, expediting the healing of perineal tissues/cesarean incision, reducing inflammation and supports faster healing. This accelerates recovery from labor and birth contributing to a quicker return to normal functionality and comfort. PBM increases cellular energy (ATP) through the mitrochondria in our cells therefore reducing postpartum depletion. This abstract briefly explores the transformative potential of light therapy in postpartum care, emphasizing its holistic approach to recovery.
Recording: https://youtu.be/8K29SqDP4uc
