Speaker: Paola Wilkin, Jane Houston, Megan Arbour
Facilitator: Paloma Terra
Postpartum Haemorrhage (PPH) remains one of Peru’s leading causes of maternal morbidity and mortality, with nearly 20% of maternal deaths caused by PPH in 2019. Early recognition of PPH and prompt treatment remains challenging in low-resource obstetric settings, including among Mestizo midwives in Peru. Midwives and obstetricians may experience barriers to the timely diagnosis and management of PPH including access to quantitative blood loss measurement methods, and timely haemoglobin blood laboratory tests. In addition, formalized PPH diagnosis and management training may not be available.
PURPOSE/AIM: The purpose of this quality improvement initiative is to increase the accuracy of postpartum blood loss measurement by Mestizo Peruvian midwives through hybrid educational sessions.
Methods: 3 international midwives collaborated to develop this quality improvement project. Clinically practicing midwives, midwifery interns, and midwifery students were recruited from the 2 main public hospitals in Arequipa, Peru to participate in a web-based training module, and subsequent live skills demonstration regarding how to quantitatively assess postpartum blood loss. The primary author is a Mestizo Peruvian dentist and midwife, and all materials were developed in a linguistically and culturally safe manner.
After the web-based training module, participants were surveyed on their level of comfort and self-efficacy with quantitative blood loss measurement using google forms, distributed via WhatsApp.
This quality improvement initiative was deemed exempt by the Frontier Nursing University IRB.
Results: Preliminary results and the next steps will be available and shared during the presentation.
Recording: https://youtu.be/UTrVPckPWUY
Title: Arte de la Partería Indígena: Resistencias, desafíos y continuidades
Speaker: Tania Pariona Tarqui
Facilitator: Paloma Terra
Los objetivos de este mapeo son: identificar organizaciones de parteras indígenas, además de delinear la situación en la que se encuentran y las experiencias que se han generado cada país, acorde a su contexto histórico y aspectos legales. Finalmente, indicar las buenas prácticas, recomendaciones y retos señalados por las organizaciones de parteras de cada país.
Uno de los elementos relevantes del mapeo, es las diferencias que existen entre el ejercicio de la partería y la relación con el Estado, esto de acuerdo al nivel organizativo alcanzado por los grupos de parteras y los avances legales en el reconocimiento de la misma. Por ejemplo, algunas parteras en sus países presentan un estado de sobrevivencia por el poco o nulo reconocimiento de los pueblos originarios y la partería indígena, en otros casos por su nivel de organización hay parteras indígenas que en sus países exigen autonomía al Estado.
Sin embargo, en todos los países se dan prácticas de control, desprestigio y criminalización. Esto realza la importancia de fortalecer las organizaciones de parteras y de los pueblos originarios para la construcción de propuestas desde los sistemas de salud indígenas y la articulación horizontal con los Estados.
Como parte de sus recomendaciones se destaca la necesidad de fortalecer el tejido organizativo entre las parteras tanto a nivel nacional como en la región, el politizar la lucha por el respeto a las parteras y todas las mujeres como sujetos de derechos para que puedan tomar decisiones informadas sobre su cuerpo, su maternidad y la atención del parto desde su propia tradición y la necesidad del cuidado de las abuelas parteras que viven en situaciones vulnerables como garante de la continuidad generacional para el cuidado de las mujeres y comunidades de los pueblos indígenas.
Recording: https://youtu.be/zuIlj3va4E4
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: Ines Rothman
Facilitator: Elisa Segoni
The population of low-risk pregnant women whose birth is induced has been increasing steadily in many countries. Considerable inter- and intraprofessional variation regarding the medical indications for induction, induction methods and induction term exists.
The Flemish Association for Midwives did a systematic literature review on the effects of induction of labour at 41 and 39 gestational weeks, both compared to expectant management, on maternal and neonatal outcomes, and on maternal birth experience. This research included almost 40 studies across the 3 PICOs between 2017-2022 and 9 guidelines.
Clinical guidelines and current care policy are based on a limited number of research studies, with significant study limitations. The evidence from our systematic literature review shows that induction does not unambiguously lead to more favourable maternal and neonatal outcomes; new systematic reviews and the wealth of observational studies in recent years more often point to no or unfavourable iatrogenic effects of induction. Induction appears to have a higher chance of a negative birth experience and the shared informed decision-making process is flawed. Women receive insufficiently balanced information about the benefits and risks of induction, the different indications, the induction process, other interventions that may accompany an induction, the impact of induction on freedom of mobility, and the right to refuse an induction. Women often experience the induction recommendation as binding rather than as a choice, sometimes feeling pressured. An open, constructive, interdisciplinary dialogue is urgently needed to evaluate current induction policies. Our research points to several implications which can enrich this debate.
Recording: https://youtu.be/iyoz_CNYZv8
Speaker: Tracy Donegan
Facilitator: Portia Shanduka
80 – 90% of women who stop breastfeeding in the first six weeks are not ready to do so. Initiatives to improve breastfeeding rates have traditionally focused mainly on social policies, support and health promotion activities. In recent years therapeutic interventions such as mindfulness and self-compassion practices are emerging as an effective tool to increase breastfeeding self-efficacy while reducing mental health complications. Traditional antenatal breastfeeding preparation overlooks the influence of a dysregulated emotional state on breastfeeding outcomes. Antenatal breastfeeding classes are a prime opportunity for midwives to provide parents with evidence-based tools to manage psychological distress during this intense transition.
Mindfulness practices support parents to manage emotional turmoil and overwhelm including those who may experience breastfeeding grief. A mindful breastfeeding class can prepare parents with more than position, latch and newborn nursing information. This hybrid approach facilitates the development of cognitive skills to cultivate mental flexibility and emotional resilience to meet common challenges of early breastfeeding with self-compassion and self-kindness. This is critically important for parents with a baby in NICU who are at increased risk of developing mental health complications due to high stress levels. Recent primary evidence suggests that a mindfulness based approach to breastfeeding and postpartum is associated with an increase in breastfeeding initiation, duration, self-efficacy, parenting confidence and improved relationship quality. Infant mental health is also impacted positively.
Recording – https://youtu.be/X_5TJjN7PR0
Speakers: Yasmin Vaughan, Kathleen Pfohl and Mariama Massaquoi
Facilitator: Hayat Gomaa
Abstract:
Skilled birth attendants, particularly midwives, play a crucial role in reducing preventable maternal and newborn deaths. In January 2024, Helping Children Worldwide collaborated with six other organizations to host a 5-day training conference on emergency procedures in maternal and newborn health in Sierra Leone. Our presentation will argue that organizations should prioritize investments in training and supporting midwives in LMICs, highlighting the positive and sustainable impact on both health outcomes and broader development goals. Further, presenters will talk in a panel discussion about best practices for these trainings, highlighting practical steps to planning a training conference, lessons learned, and the value that collaboration brings to this work.
Recording: https://youtu.be/4hH_S_kiCis
Speaker: Kate Stringer
Facilitator: Portia Khanyile Shanduka
Abstract:
An exploratory assessment of a global health partnership (GHP) for midwives between the UK and India. India has recently embarked on a transformative maternal health program to strengthen midwifery training across the country. UK midwives from a South East NHS Trust were partnered with midwives in Hyderabad, India in a project designed to strengthen midwifery leadership. Education resources were provided via online systems and a clinical site visit was undertaken. Aim To explore Indian and UK midwives’ experiences of participating in a global health partnership including what were the reciprocal perceived benefits and challenges in knowledge and leadership capability and development for both groups of midwives participating in the project. Method A qualitative exploratory study using semi-structured qualitative interviews to provide insight into participants’ experience of participating in the GHP following the conclusion of the project. Participants consisted of 14 UK and Indian midwives. Results Midwives in all settings found the partnership beneficial. Participants shared enhanced leadership capacity including examples of compassionate leadership and emotional intelligence. The GHP had provided a renewed sense of worth and encouraged continuing advocacy in a challenging environment Conclusion Midwives in all settings demonstrated enhanced leadership skills. The UK midwives reported increased joy and satisfaction in their UK roles. The research findings suggest GHP opportunities for UK midwives may offer leadership growth and retention opportunities for the NHS.
Recording: https://youtu.be/yWZ1hjKxrB4
