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
Speaker: Patricia Marianella
Facilitator: Paloma Terra
El objetivo fue comparar los resultados materno-neonatales y costos de la resolución de embarazos, en mujeres obesas y con peso normal pregestacional.
Métodos: Estudio transversal realizado en 60 gestantes con obesidad y 120 con peso normal pregestacional atendidas en un hospital público de Lima durante el 2018, seleccionadas aleatoriamente. Se recolectaron datos sociodemográficos, indicadores maternos (índice de masa corporal pregestacional, controles prenatales, edad gestacional, días de hospitalización), neonatales (Apgar, peso, morbilidad, edad gestacional por examen físico, días de hospitalización) y datos de los costos (medicamentos, procedimientos e insumos). Se utilizó la prueba estadística U de Mann Whitney.
Resultados: Se encontraron diferencias entre mujeres obesas y con peso normal pregestacional en los días de hospitalización materna (3 ±1,2 días vs 2,0 ±1,2 días; p=0,000); en el peso del recién nacido (3 615 ± 518,03 gr vs 3 245 ± 426,25 gr; p=0,000), en el costo de medicamentos ($ 19,78 ±16,47 vs $ 3,21 ±15,57; p=0,000), en el costo de procedimientos ($ 40,65 ±46,78 vs $ 27,67 ±49,47; p=0,001), y en el costo de insumos ($ 54,08 ±29,02 vs $ 9,32 ±28,26; p=0,000).
Conclusión: Las mujeres obesas presentaron recién nacidos con mayor peso, contaron con más días de hospitalización y los costos de medicamentos, procedimientos e insumos fueron superiores en comparación con las mujeres de peso normal.
English:
The objective was to compare maternal-neonatal outcomes and costs of pregnancy resolution in obese women and women with normal pregestational weight. Methods: Cross-sectional study conducted in 60 pregnant women, randomly selected, with obesity and 120 with normal pregestational weight attended in a public hospital in Lima during 2018. Sociodemographic data, maternal indicators (pregestational body mass index, prenatal controls, gestational age, days of hospitalization), neonatal (Apgar, weight, morbidity, gestational age by physical examination, days of hospitalization) and cost data (drugs, procedures and supplies) were collected. The Mann Whitney U statistical test was used. Results: Differences were found between obese and pregestational normal weight women in maternal hospitalization days (3 ±1.2 days vs. 2.0 ±1.2 days; p=0.000); in newborn weight (3 615 ± 518.03 gr vs. 3 245 ± 426.25 gr; p=0.000), in the cost of medications ($ 19.78 ±16.47 vs $ 3.21 ±15.57; p=0.000), in the cost of procedures ($ 40.65 ±46.78 vs $ 27.67 ±49.47; p=0.001), and in the cost of supplies ($ 54.08 ±29.02 vs $ 9.32 ±28.26; p=0.000).Conclusion: Obese women had heavier newborns, more days of hospitalization and the costs of medications, procedures and supplies were higher compared to women of normal weight.
Recording: https://youtu.be/McAV7M1Ub4M
Speakers: Linley Taylor and Claire Macdonald
Facilitator: Linda Deys
Abstract:
Background – Natural disasters are usually unexpected and sudden, carrying prolonged after-effects for communities. Throughout disasters, pregnant women and people continue to give birth, so midwives must continue providing essential care for pregnancy, labour and birth and postpartum. Aotearoa New Zealand has universal health coverage for maternity care through a community midwifery continuity-of-care model, integrated with hospital-based midwifery and obstetric services. This enabled continuous care provision throughout the Canterbury earthquakes in 2011-2012, and Cyclone Gabrielle in Hawke’s Bay in 2023. However, there were unforeseen challenges. In a high-resource country, the unexpected loss of transport (including road damage) and phone/internet connectivity during the cyclone highlighted our heavy reliance on technology. Discussion – We share experiences from practice in the midwifery caseloading model which enabled a nimble and often autonomous response to meet clients’ needs. Factors supporting midwives’ care provision were: responsibility for a caseload; carrying full homebirth kits in their cars; group practice arrangements; strong interdisciplinary collegial relationships; integration with hospital services; and national support from the College of Midwives. Planning for the future should include infrastructural support for community midwives; satellite internet phone connectivity; access to generators and fuel; the inclusion of community health provision in Civil Defence planning; and contemplation by midwives as to how ready they might be in their personal lives if disaster struck today. Conclusion – Community caseloading midwifery models should be protected, supported and included in future disaster planning.
Recording: https://youtu.be/vEe1E2iBTJY
