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: Wendy Foster
Facilitators: Belle Bruce and Siti Khuzaiyah
Problem: Across the globe midwives are leaving the profession. Moral distress may contribute to this attrition. While moral distress is broadly understood within health care disciplines a contextual understanding of moral distress in midwifery is limited. Current tools available to screen for moral distress are not as suitable for use in midwifery practice.
Methodology: This project is an exploratory sequential mixed methods design that occurred across four phases; concept analysis, in-depth interviews, an e-Delphi study and a pilot study. This presentation will present key findings from the first three phases.
Results: Midwives report feeling demoralised and confirmed the presence of moral distress in practice due to excessive workloads, unnecessary intervention and hierarchical medical systems. Health care organisations are identified as placing midwives in morally compromising situation that are significant factors in the development of moral distress. Negative psychological outcomes are a key feature in moral distress with midwives describing symptoms of work-related stress and anxiety, increased sick/personal leave, feelings of powerlessness and burnout. Importantly it was identified that moral distress was likely to occur across a continuum from low (moral frustration), moderate (moral distress) and severe (moral injury). A pilot tool to screen for moral distress across a continuum has been developed.
Conclusion: Moral distress is a significant issue in midwifery practice. The development of the midwifery moral distress screening tool has enhanced the conceptual understanding. This study has provided additional language for midwives to describe their experiences and may assist organisations to identify and address ethical challenges within workplaces.
Recording https://youtu.be/Czfj3EUg6g4
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: Betsy Arnold-Leahy
Facilitator: Ally Anderson
Abstract:
Occiput Posterior position is a variation of the normal birthing process, a complication of birth requiring patience, intervention, or something in between. Occiput Posterior Position of the fetus is often referred to as “the most common” fetal malposition or as a variation of normal. As many as 30% of fetuses spend some time in this position during labor only 5-12% will remain so for the actual birth. Persistent Occiput Posterior Position may account for up to 18% of cesarean births as well as increased operative births, along with maternal and neonatal morbidity and mortality. Anecdotally, many birthing people are increasingly worried if their fetuses are posterior even at early gestations because of the knowledge available in the media.
Midwives and accoucheurs have encountered this fetal position as documented into the Middle Ages (Louise Bouchard, Jane Sharp). Current data and research and strategies the management of Occiput Posterior position present the intersection of the ART and SCIENCE of midwifery. However most current data is based in Eurocentric literature. Only recently has there been literature from Spain, China, Japan, and Iran to name a few midwives from. Even these studies often reference the primarily English language literature aforementioned in their citations. Very rarely is there an article from a non-Eurocentric area where midwives and traditional birth attendants are prevalent.
This presentation will focus on other perspectives on midwifery management of Occiput Posterior the non-primarily English-speaking voices that are emerging in literature focusing on this topic. The purpose is to highlight what strategies and options are available to those midwives providing care for birthing people particularly in those areas prone to disruptions in care due to conflict and disaster. What can we learn and how can we further support one another?
Check the time in your location: https://bit.ly/VIDM24-session-14
Access: zoom link here: https://frontier.zoom.us/j/81953226873?pwd=tnaEumJ5LXfI521IKce2l9KyWkxieT.1
Recording: https://youtu.be/3PNmcSoyfHE
