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
Speaker: Nurul Hidayah
Facilitator: Gita Nirmala Sari and Mahanutabah Hamba Qurniatillah
Latar Belakang: Kehamilan remaja merupakan kehamilan yang terjadi pada usia remaja kurang dari 20 tahun. Depresi postpartumadalah suatu kondisi depresi berat yang terjadi dalam 4-6 minggu setelah melahirkan. Tujuan: Menggali bukti ilmiah kebidanan terkait kejadian depresi postpartum pada ibu remaja. Desain: scoping review menggunakan ceklist PRISMA-ScR Metode: Penulis menggunakan kerangka Arksey dan O’Malley. Pencarian artikel menggunakan tiga databased PubMed, Proquest, Science Direct yang mencakup dari Januari 2012 sampai 2022. Alat penilaian digunakan. Seleksi review dan karakterisasi dilakukan dengan penilaian critical appraisal menggunakan studi Joanna Briggs Institude (JBI) tool. Hasil: Dari 809 artikel yang berpotensi relevan, 7 artikel dimasukan. Artikel penelitian tersebut berasal dari 5 Negara yang berbeda, dan metode RCT, Cross sectional dan kualitatif. Hasilnya disajikan dalam tiga tema : Prevalensi depresi postpartum pada ibu remaja, faktor resiko depresi postpartum pada ibu remaja dan pelaksanaan layanan kesehatan dan hambatan dalam menangani depresi postpartum pada ibu remaja.
Kesimpulan: Berdasarkan 7 artikel yang dilakukan review, ditemukan bahwa bahwa 32% ibu remaja memiliki kemungkinan depresi postpartum yang memerlukan tindakan segera pada penilaian awal, deteksi dan intervensi. Faktor-faktor yang berkontribusi terhadap perkembangan depresi postpartum pada ibu remaja termasuk dukungan sosial yang tinggi, masalah perkawinan, tekanan dari orang tua dan masalah ekonomi. Asuhan kebidanan berkesinambungan, strategi dan tindakan pencegahan yang tepat termasuk skrining secara berkala untuk ibu remaja dan penyedia layanan mental diperlukan untuk mengurangi resiko depresi postpartum pada ibu remaja.
English:
Background: Teenage pregnancy is a pregnancy that occurs in adolescents less than 20 years old. Postpartum depression is a condition of major depression that occurs within 4-6 weeks after delivery. Objective: Explore obstetric scientific evidence related to the incidence of postpartum depression in adolescent mothers.
Design: scoping reviews using PRISMA-ScR checklist Method: The author uses the Arksey and O’Malley frameworks. The article search uses three databases PubMed, Proquest, Science Direct covering from January 2012 to 2022. Assessment tools are used. Review selection and characterization were carried out by critical appraisal assessment using the Joanna Briggs Institude (JBI) tool.Result: Of the 809 potentially relevant articles, 7 were entered. The research articles are from 5 different Countries, and RCT, Cross sectional and qualitative methods. The results are presented in three themes: The prevalence of postpartum depression in adolescent mothers, risk factors for postpartum depression in adolescent mothers and the implementation of health services and obstacles in dealing with postpartum depression in adolescent mothers.
Conclusion: Based on 7 articles reviewed, it was found that 32% of adolescent mothers have a chance of postpartum depression that requires immediate action on initial assessment, detection and intervention. Factors contributing to the development of postpartum depression in adolescent mothers include high social support, marital problems, pressure from parents and economic problems. Ongoing obstetric care, appropriate strategies and precautions including periodic screening for adolescent mothers and mental care providers are needed to reduce the risk of postpartum depression in adolescent mothers.
Recording: https://youtu.be/x2ko_70X4qY
Speakers: Tanya Capper and Bridget Ferguson
Facilitator(s): Linda Deys
Abstract:
Safe and high-quality maternity care is crucial for ensuring the best possible health outcomes for both mothers and newborns (Renfrew et al., 2014). Unfortunately, recent incidents of preventable harm taking place within maternity services have underscored the importance of whistleblowing (Kirkup, 2022; Ockenden, 2022). Whistleblowing involves reporting incidents of wrongdoing with the goal of putting an end to poor practices and reducing risk. However, the act of whistleblowing may be met with significant barriers and adversity for the individual blowing the whistle. This presentation aims to discuss the findings of a scoping literature review that explores the experiences of health professionals, including midwives, who find themselves in the position of whistleblowing. The presentation will explain the key issues, barriers, and challenges that current literature has reported regarding whistleblowing in maternity services. These include the structural power that enforces silence, inadequate responses to whistleblowing, and the mechanisms by which whistleblowing is suppressed. It will also delve into the process of weighing up the personal risk to the whistleblower versus the moral obligation to protect mothers and infants.
Recording: https://youtu.be/DL-1qHliG9Y
Speaker: Belle Bruce
Facilitator: Louela Cordova-Acedara
Abstract:
Background: There is a major research gap relating to the impact of intravenous (IV) fluids administration during labour on maternal and neonatal outcomes. It is biologically plausible that a relationship between volume of IV fluids and primary postpartum haemorrhage (PPH) exists. Aim: To investigate the relationship between intrapartum IV fluids and PPH. Methods: A retrospective cohort study was conducted in a tertiary hospital from September 2021 to September 2022. Inclusion criteria were singleton pregnancy, planning a vaginal birth, and admitted for labour and birth care between 37-42 weeks gestation. The study factor was IV fluids during labour. The primary outcome was primary PPH. Birth and postnatal data were obtained from the electronic medical records and paper fluid order documentation. Secondary outcomes included caesarean section and neonatal weight loss following birth. Results: 1023 participants were included of which 339 had a PPH (33.1%). Our main finding was that there was no association between high-volume IV fluids (≥2.5L) and PPH after adjusting for demographic and clinical factors (ORadj1.02 CI: 0.72, 1.44). However, there was a positive association between high-volume IV fluids and caesarean section (ORadj 1.99; CI: 1.4, 2.8) and neonatal weight loss (ORadj 1.8; CI: 1.09, 2.0). Conclusions: These findings are important to further knowledge relating to the administration of IV fluids in labour and the potential impact of this common practice. It identifies future research priorities around documentation of IV fluids and their relationship with pregnancy and perinatal outcomes.
Recording: https://youtu.be/sjOijsnYkWM
