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: Florence Wilcock
Facilitator: Ally Anderson and Liticia Arthur
I am fortunate to work in the UK NHS within a midwifery-based system of maternity care where the role of the midwife is well recognised and respected. Despite this maternity care can sometimes break down and become a ‘them and us culture’ with conflict between different staff groups with midwives perhaps seen as advocates for women in contrast to obstetricians using a more paternalistic and medicalised model. I know in other regions in the world this can be even more marked with very obstetric based models and obstetric nurses in some countries or else with limited access to either profession in others. In this talk I will discuss my experiences of working alongside midwifery colleagues to try and enable women centred holistic care as well as making some suggestions of how you might build effective working relationships with obstetric colleagues.
(FRCOG aka TheObsPod)
Recording: https://youtu.be/jx2ANo8ZmnE
Speaker: Lieselotte Vandeputte and Elke Van Den Bergh
Facilitator: Eunice Atsali and Hannah Yawson
The annual report on midwifery-led care during childbirth focusses on midwifery-led care in Belgium. It is the second report to address the underreporting and need for transparency of the work that midwives do autonomously in Belgium.
Design and setting: The research was conducted through an online registrations form. Midwives could register each birth they attended or autonomously performed. 31 midwifery practices with 108 self-employed midwives primarily employed in Flanders and Brussels participated in this registration. Measurements and findings: In total 1,587 labours that started in first line and were also initially planned to give birth in first line under supervision of the midwife were registered. Of these 1,587 registrations, 1,311 deliveries were performed autonomously by the midwife: 695 deliveries took place at home, 278 deliveries were assisted in a hospital, 155 deliveries in a birthing house and 182 in a midwifery led unit inside of a hospital. One delivery took place on the way to the hospital. Finally, 276 women were referred intrapartum to the hospital for medical reasons after which delivery took place under the supervision of the gynecologist.
Key conclusions: MLC is safe and of high quality. Women have a higher chance of a physiological birth. Maternal and neonatal outcomes are excellent and in line with scientific literature. Implications for practice: There is a need for expanding the research into French speaking Belgium and to disseminate more the good results of midwifery led care as a safe and valid birth choice, given the increased demand for it.
Recording: https://youtu.be/99ko4df0kdc
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
