Speaker: Elizabeth Arnold-Leahy
Facilitator: Caitlin Goodwin
Persistent Occiput Posterior Position of the fetus is the most common variation or malposition during labor. Despite a midwife’s knowledge that 90% of Occiput Posterior fetuses will rotate to Occiput Anterior during the course of labor either spontaneously or with coaxing, we also know the abominable outcome statistics for birthers whose fetuses remain posterior. These births are associated with higher rates of operative intervention, as well as maternal and neonatal morbidity.
Midwives have a variety of techniques to facilitate the rotation such as repositioning, exercises. The ultimate technique in the midwife’s tool bag is Manual Rotation which has been shown to increase rates of vaginal birth. Current global midwifery research on strategies and techniques, risks, benefits, alternatives, education and considerations, incidence for outcomes, sequelae, and community and hospital site considerations are reviewed. This presentation will discuss of various strategies to promote and facilitate rotation to Occiput Anterior will be presented
Recording https://youtu.be/qF_DCXhKyPc
Speaker: Rizka Ayu Setyani
Facilitator: Terri Downer and Scarlet Woolcott
One of the obstacles to handling HIV is late diagnosis due to a lack of access to diagnostic services in health facilities. In addition, the negative stigma against this disease also makes people reluctant to diagnose at health facilities. Early diagnosis needs to be done, especially in pregnant women, as an essential condition that needs to be known in childbirth and breastfeeding. Unfortunately, the HIV testing policy in Indonesia still has loopholes for the mother or the patient to refuse to take the HIV test. Health workers are required to offer HIV testing, but the mother’s voluntary willingness determines the HIV test. This implementation trial pilot study used random cluster sampling to select seven intervention and seven control sites in Yogyakarta city, Indonesia. Seven intervention health facilities used the EKSTRIM website for three months, from January through April 2022, to educate and do HIV counselling with pregnant women patients. EKSTRIM website was designed for use on mobile phones to improve HIV testing among pregnant women. Health workers managed to record 1,594 visits and were able to increase HIV testing by 6.7% in pregnant women. The EKSTRIM pilot demonstrated the feasibility of implementing a digital healthcare-integrated solution in a low-resource setting, health worker capacity building and patient self-care into a single robust and responsive system. Although the implementation phase was only three months, the pilot generated evidence that EKSTRIM could increase HIV testing uptake.
Recording: https://youtu.be/tG1Vs6rwvHQ
Title: Professional Midwifery: Revolutionising Maternal Care in India
Speaker: Indie Kaur
Facilitators: Red Miller and Suman Lata
Research shows that midwife-led care reduces unnecessary interventions, and mothers go on to have better birth experiences. In 2011, Fernandez Hospital piloted an in-house professional midwifery education and training program when such a cadre did not exist in India. Unnecessary interventions like episiotomies and epidurals decreased, and women’s positive feedback increased yearly. Looking at this success, the Government of Telangana and UNICEF partnered with Fernandez Hospital to pilot midwifery training in its public hospitals.
These midwives created a paradigm shift in maternity care, helped increase normal births, and promoted respectful maternity care in the state’s public facilities. This led to the government investing in the need for separate training for midwives in India and launching ‘Guidelines on Midwifery Services’ in 2018. This was a historic moment for midwifery in the country, recognising the need for a separate professional training building on a strong cadre and rolling our midwifery care to women and new-born in the country.
The Foundation has since partnered with The Government of India and Telangana State with the support of The World Health Organisation (WHO) and UNICEF to train midwifery educators in India, strengthening midwifery services.
Speaker: Joy Kemp and Sharmin Shobnom Joya
Facilitator: Aisha Salihu Abdullahi
A 5-year twinning partnership between the Bangladesh Midwifery Society (BMS) and the Royal College of Midwives UK was completed and evaluated in 2022; results will be shared in this presentation. Twinning was both organisational and individual. Midwives are new in Bangladesh; they are negotiating professional space. UK midwifery is more established but the workforce is not representative of the population with Bangladesh heritage (1%); maternal and perinatal outcomes are worse for South-Asian families. Therefore, twinning had potential benefit for both contexts.
Objective: To evaluate if twinning had mutual benefit, especially in strengthening midwifery leadership.
Methods: A mixed methods enquiry using document-review, surveys, focus-groups, key informant interviews and participant observation. Evaluation framework informed by OECD criteria and stakeholder questions. Thematic data analysis.
Results: BMS’ organisational capacity increased significantly during the partnership. Fifty-one young midwife leaders in Bangladesh were developed and six won international leadership fellowships. Seven quality- improvement projects in Bangladesh were successfully completed, advancing midwifery services. UK midwives valued and learned from their participation. The partnership enabled greater engagement with South Asian diaspora midwives in the UK and highlighted inequity of UK maternity outcomes. The COVID-19 pandemic brought both challenges and opportunities for innovation.
Conclusions/Summary: This partnership strengthened midwifery associations and midwifery leadership and impacted every area of the ICM’s Professional Framework in Bangladesh. Twinning facilitated reciprocal benefits in both countries and may be replicable in other contexts.
Recording: https://youtu.be/jCiv_7LqMnA
Speaker: Florence Wilcock
Facilitator: Ally Anderson and Liticia Arthur
I am fortunate to work in the UK NHS within a midwifery-based system of maternity care where the role of the midwife is well recognised and respected. Despite this maternity care can sometimes break down and become a ‘them and us culture’ with conflict between different staff groups with midwives perhaps seen as advocates for women in contrast to obstetricians using a more paternalistic and medicalised model. I know in other regions in the world this can be even more marked with very obstetric based models and obstetric nurses in some countries or else with limited access to either profession in others. In this talk I will discuss my experiences of working alongside midwifery colleagues to try and enable women centred holistic care as well as making some suggestions of how you might build effective working relationships with obstetric colleagues.
(FRCOG aka TheObsPod)
Recording: https://youtu.be/jx2ANo8ZmnE
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: Jialu Qian
Facilitator: Heather Brigance
Purpose: The psychological outcomes for many parents who experience perinatal loss depend on nurses’ and midwives’ ability to provide effective bereavement support. However, most nurses and midwives lack the ability in this field. The aim of the study was to explore obstetric nurses and midwifery professionals’ experiences with the Perinatal Bereavement Care Training Programme (PBCTP) after implementation.
Method: This qualitative study was conducted at a tertiary level maternity hospital in China. The PBCTP was implemented from March to May 2022. A total of 127 nurses and 44 midwives were invited to participate in the training. Obstetric nurses and midwives studied a 5-module training programme comprised of 8 online theoretical courses. Semi-structured telephone interviews were conducted with 12 obstetric nurses and 4 midwives from May to July 2022 as a post-intervention evaluation. Thematic analysis was used in the data analysis.
Results: Six main themes within participants’ experiences of PBCTP intervention were identified: aims of the training; personal growth and practice changes after training; the most valuable training content; suggestions for training improvement; directions for practice improvement; influencing factors of practice optimisation.
Conclusion: Nursing and midwifery professionals described the PBCTP as satisfying their learning and skills enhancement needs and supporting positive changes in their care providing for bereaved families. The optimised training programme should be widely applied in the future. More efforts from the hospitals, managers, obstetric nurses and midwives are needed to contribute to forming a uniform care pathway and promoting a supportive perinatal bereavement care practice.
Recording: https://youtu.be/sx7DJdpik9I
