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: 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
Title: Changing the course of history – Midwives, Midwifery
Speaker: Jacqueline Dunkley-Bent
Facilitator(s): Cecilia Jevitt
This session describes the impact of midwives as a ripple through generations and the significant contribution midwives make throughout the life course. Listeners will be challenged to reflect on their contribution to childbirth experiences and outcomes within the context of the changing world. Years from now will we throw up our hands or role up our sleeves? The session will end with a call to action.
Recording: https://youtu.be/RNcRroY3U2k
Speaker: Robin Cronin
Facilitator(s): Cecilia Jevitt and Erni Rosita Dewi (Shadow)
Abstract:
Background: Diabetes in pregnancy is diagnosed in 6% of pregnancies annually in Aotearoa-New Zealand, disproportionately affecting multi-ethnic, low socio-economic women. Little is known about the care experience of this population within the model of midwifery continuity-of-care, including views of telehealth care. Aim: Increase understanding of the experience of diabetes in pregnancy care, including telehealth, among multi-ethnic, low socio-economic women receiving midwifery continuity-of-care. Methods: Qualitative interview study with primarily indigenous and migrant women who had diabetes in pregnancy and gave birth 6-18 months previously. Interviewers were matched with participants by ethnicity. Transcripts were analysed using Framework analysis. Results: Participants were 19 women (5 Māori, 5 Pacific Peoples, 5 Asian, 4 European). Data analysis revealed three key themes: 1) ‘shock, shame, and adjustment’ to the diagnosis 2) ‘learning to manage diabetes in pregnancy’ and 3) ‘preparation for birth and beyond’ to the postpartum period. Discussion: Receiving the diagnosis of diabetes in pregnancy was a shock. Managing diabetes during pregnancy was particularly challenging for indigenous and migrant women, who wished for better access to culturally appropriate dietary and lifestyle information. Women appreciated having options of telehealth and face-to-face consultations. Preparation for birth and postpartum diabetes follow-up were areas requiring significant improvement. Challenges were mitigated through care from a consistent diabetes specialist midwife and community-based midwifery continuity-of-care. Conclusion: Midwives were the backbone of diabetes in pregnancy care for this multi-ethnic, low socio-economic population. Care could be improved with more culturally appropriate diet and lifestyle information, better birth preparation, and expanded postpartum diabetes support.
Recording: https://youtu.be/aWiwZak0Jog
The Role of Midwifery in Respectful Maternal Care and Mental Health through the Wellbeing Foundation Africa’s Mamacare360 Program
Speaker: Toyin Saraki
Co-Presenters: Dr. Pragya Vishwakarma, Ms. Eunice AlexGreat Akhigbe
Facilitator(s): Halima Abdul
Abstract:
The Mamacare360 program, implemented by the Wellbeing Foundation Africa (WBFA) Midwives, is aligned with Goal 3 of the United Nations Sustainable Development Goals, which aims to ensure good health and wellbeing for all. Central to its mission is the enhancement of maternal health through the promotion of Respectful Maternity Care (RMC) for all women throughout the continuum of pregnancy, childbirth, and the postnatal period. Recognising the pivotal role of the relationship between pregnant women and their primary healthcare providers in shaping health outcomes for both mother and newborn, WBFA highlights the significance of this connection in fostering postnatal health and wellbeing.
Respectful maternity care is upheld as a fundamental human right, deserving of every childbearing woman within every healthcare system globally (WRA, 2010). WBFA advocates for this principle, emphasising the inherent dignity and autonomy of women throughout the childbirth process. This ethos is echoed in the Lancet Midwifery Series (2014), which asserts that midwifery is indispensable in addressing the challenges associated with delivering high-quality maternal and newborn care universally. Moreover, it is recognized as an effective strategy for promoting the health and wellbeing of women of reproductive age, newborns, and their families, thereby exerting a significant and sustainable impact on population health outcomes. Through a grassroots and community-led approach, Mamacare360 not only delivers essential maternal and child health services but also fosters a culture of empowerment and resilience among women.
This presentation will explore the multifaceted impact of Mamacare360, with a particular emphasis on the transformative power of midwifery. By bringing skilled midwives directly to the doorsteps of communities, the program ensures access to quality prenatal, childbirth, and postnatal care, thereby reducing maternal and infant mortality rates. By engaging with local women as advocates and educators, Mamacare360 cultivates a sense of ownership over maternal health, fostering sustainable improvements in healthcare-seeking behaviours.
The Mamacare360 program also acknowledges the often-overlooked aspect of maternal mental health. Recognising the profound impact of psychological wellbeing on maternal and child outcomes, the program integrates mental health support into its holistic approach. Through counselling, peer support groups, and community outreach initiatives, Mamacare360 addresses the unique challenges faced by mothers, promoting mental resilience and overall wellbeing.
Recording: https://youtu.be/8l4fhB_1C88
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
Enhancing Obstetric Prehospital Care: Insights from Midwives in Lima, Peru
Speaker: Ginger Garcia
Facilitator(s): Susana Ku
Abstract:
This presentation delves into the experiences of a dedicated group of midwives in Lima, Peru, who possess specialized training to provide prehospital care during natural disasters. Peru’s diverse climate often leads to natural disasters that directly impact communities, underscoring the critical need for immediate attention in such situations. While the overarching approach is holistic, special emphasis is placed on the most vulnerable populations, including women, children, and the elderly. The goal is to deliver swift and timely care, focusing on prevention and support for women amidst crises. Furthermore, sustainability is prioritized, with an emphasis on resource efficiency and waste reduction, promoting natural childbirth, exclusive breastfeeding, and optimal nutrition. Recognizing the adverse effects of climate change on maternal and fetal health, proactive measures are taken to address eventualities swiftly and effectively.
Check the time in your location: https://bit.ly/VIDM24-closing-session
Recording: Not Available
