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: Alison Eddy and Carol Bartle
Facilitator(s): Catherine Salam (Izza Alifina)
Abstract:
Te Kāreti O Nga Kaiwhakawhanau Ki Aotearoa | The NZ College of Midwives and their college members are promoting midwifery action on climate change and working towards supporting national and global initiatives which reduce the negative impacts of climate change. Wherever they work midwives can consider the environment and identify ways to minimise their impact both personally and professionally. Small actions can grow into a significant movement and midwives can advocate for social change in relation to sustainability and healthy environments. The ‘fingerprint of climate change’ has been described as beginning before a baby is born due to pregnant women already enduring environmental crises that their children will be exposed to after birth.[1] This presentation tracks how an increased awareness of the impact of climate change sparked the College into action aimed at supporting some mitigation of climate change via a lens on midwifery practice related to pregnancy, birth, and infant feeding. The College recognises the potential for midwifery globally to develop a model of excellence for climate action and sustainability and we will present what we have achieved so far, and the steps we are taking towards collective action.
[1] Pacheco, S. (2020). Catastrophic effects of climate change on children’s health start before birth. The Journal of Clinical Investigation, 130(2),562-564.
Recording: https://youtu.be/LRidySKzuBU
Speaker: Melanie Welfare
Facilitator: Cecilia Jevitt
Abstract:
Many midwives enter the profession with a dream and internalised vision of the midwife they want to be, how they will work with women, families, and other healthcare professionals. This vision becomes part of and adds to their midwifery identity. However, within the profession, there is often a dichotomy between the midwife you want to be and the increasingly challenging climate of midwifery. This can lead to midwives having to consider how they remain personally and professionally sustainable within the workforce. There is a growing body of evidence scrutinising the issue of retaining midwives in the workforce, with several studies highlighting midwifery burnout, exacerbated by increasing workload, bullying, and financial constraints. Themes from qualitative research conducted in New Zealand with employed and self-employed midwives will be presented. These included continuity of care/partnership, midwifery identity, and career progression. One of the main themes that emerged was the notion of being an ‘ideal’ midwife who was able to remain personally and professionally sustainable by changing work settings. This presentation will discuss what midwives felt made them an ideal/good midwife and the guilt and stress that arose when they were unable to maintain their own internalised midwifery identity
Recording: https://youtu.be/l4fZUwZLYu4
