Title: Biomechanics for birth: New learning & insights for practice: The 3 R’s
Speaker: Molly O’Brien
Facilitator: Linda Wylie
Midwifery work is wide ranging. In essence we are public health practitioners, protecting, maintaining and enhancing the health and wellbeing of women and their families. As skilled practitioners we seek to understand and mitigate myriad factors that contribute to ill health while aiming to support and optimise birth physiology as per our code of proficiency.
Specifically, the presentation focuses on labour dystocia and the midwifery skill of recognising when birth goes awry using the art and science of watchful attendance. It looks at ways to support physiology to reduce difficulties during the birth process and seeks to resolve mechanical difficulties by optimising physiology including the use of biomechanical techniques.
This presentation highlights areas of midwifery training and education that hinder understanding of anatomy and physiology in relation to the birth process and the baby’s journey through the pelvis. It examines the impact the dominant biomedical model of care has on midwifery practice, the profession as a whole and the women who use the service.
Recording: youtube.com/watch?v=FVN63zUtXXI
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: Margaret Jowitt
Facilitator: Adetoro Adegoke
In ancient times Hippocrates considered that at the appointed hour the fetus put its feet against the fundus of the uterus and pushed but for the last 500 years the baby has been relegated to being a passenger in the story of birth. In the 21st century it is time to consider how material and structural remodelling of the uterus and cervix in the last four weeks of pregnancy unleash the body’s ability to help the birthing baby find the best way through the pelvis. At crowning, the fetus activates his mother’s fetal ejection reflex to release oxytocin and complete his journey. The mother and fetus need to move instinctively to enable each to act on the other to effect a straightforward birth.
Being with women throughout labour, midwives are ideally placed to advance scientific knowledge of how birth works. They observe the evolving hormonal milieu as labour progresses, they see how the mother’s mind and body work in concert with her fetus to provide a smooth passage. They recognise the importance of the social, emotional and physical environment in facilitating or impeding birth. A better understanding of the mechanobiology of birth will avoid aggressive medical and surgical intervention which can disrupt the transition to confident motherhood.
The art of midwifery is to educate and inspire the mother to trust the power of her body and her baby to work together in birth, and also to recognise when more help is needed to achieve a safe birth.
Recording: https://youtu.be/K5xj_GBnhVY
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: 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
Speakers: Cindy Farley, Jo Lethermon and Emily Western
Facilitators: Ally Anderson & Kinanthi Lebdawicaksaputri(shadow)
Abstract:
Moxibustion refers to the practice of burning the herb “moxa”- mugwort or Artemistae argyi – for its health properties. This practice originated from traditional Chinese medicine. Its most common use in childbearing populations is to assist in turning a breech presenting fetus to vertex prior to labor. This practice has an abundance of evidence attesting to its effectiveness with limited or no harm, and yet it is not often used, in part, due to providers’ lack of understanding. Hypnobirthing is a set of techniques that aim to give women and birthing people a more serene and joyful birthing experience by minimizing the pain and stress commonly associated with labor. Hypnobirthing involves training related to physiologic birth processes, relaxation techniques, self-hypnosis, visualization, light touch, and breathwork. It is taught in classes or workshops and can be supplemented with audio recordings and reading materials. It does not guarantee a completely pain-free labor, however, studies show that many women who use hypnobirthing techniques report having a less painful and more positive birthing experience. Sustaining midwifery mastery of alternative and complementary therapies that provide options to our patients requires education and support. Two Georgetown midwifery students will share the latest information about these therapies in the 9th annual Georgetown University Student Café at the VIDM. Integrative therapies offer a more wholistic approach to health care that combines techniques from several disciplines to be used in lieu of or in conjunction with medical treatments depending on the conditions and patient preference.
Recording: https://youtu.be/JCJzjLVHoN8
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
