Speaker: Nurul Hidayah
Facilitator: Gita Nirmala Sari and Mahanutabah Hamba Qurniatillah
Latar Belakang: Kehamilan remaja merupakan kehamilan yang terjadi pada usia remaja kurang dari 20 tahun. Depresi postpartumadalah suatu kondisi depresi berat yang terjadi dalam 4-6 minggu setelah melahirkan. Tujuan: Menggali bukti ilmiah kebidanan terkait kejadian depresi postpartum pada ibu remaja. Desain: scoping review menggunakan ceklist PRISMA-ScR Metode: Penulis menggunakan kerangka Arksey dan O’Malley. Pencarian artikel menggunakan tiga databased PubMed, Proquest, Science Direct yang mencakup dari Januari 2012 sampai 2022. Alat penilaian digunakan. Seleksi review dan karakterisasi dilakukan dengan penilaian critical appraisal menggunakan studi Joanna Briggs Institude (JBI) tool. Hasil: Dari 809 artikel yang berpotensi relevan, 7 artikel dimasukan. Artikel penelitian tersebut berasal dari 5 Negara yang berbeda, dan metode RCT, Cross sectional dan kualitatif. Hasilnya disajikan dalam tiga tema : Prevalensi depresi postpartum pada ibu remaja, faktor resiko depresi postpartum pada ibu remaja dan pelaksanaan layanan kesehatan dan hambatan dalam menangani depresi postpartum pada ibu remaja.
Kesimpulan: Berdasarkan 7 artikel yang dilakukan review, ditemukan bahwa bahwa 32% ibu remaja memiliki kemungkinan depresi postpartum yang memerlukan tindakan segera pada penilaian awal, deteksi dan intervensi. Faktor-faktor yang berkontribusi terhadap perkembangan depresi postpartum pada ibu remaja termasuk dukungan sosial yang tinggi, masalah perkawinan, tekanan dari orang tua dan masalah ekonomi. Asuhan kebidanan berkesinambungan, strategi dan tindakan pencegahan yang tepat termasuk skrining secara berkala untuk ibu remaja dan penyedia layanan mental diperlukan untuk mengurangi resiko depresi postpartum pada ibu remaja.
English:
Background: Teenage pregnancy is a pregnancy that occurs in adolescents less than 20 years old. Postpartum depression is a condition of major depression that occurs within 4-6 weeks after delivery. Objective: Explore obstetric scientific evidence related to the incidence of postpartum depression in adolescent mothers.
Design: scoping reviews using PRISMA-ScR checklist Method: The author uses the Arksey and O’Malley frameworks. The article search uses three databases PubMed, Proquest, Science Direct covering from January 2012 to 2022. Assessment tools are used. Review selection and characterization were carried out by critical appraisal assessment using the Joanna Briggs Institude (JBI) tool.Result: Of the 809 potentially relevant articles, 7 were entered. The research articles are from 5 different Countries, and RCT, Cross sectional and qualitative methods. The results are presented in three themes: The prevalence of postpartum depression in adolescent mothers, risk factors for postpartum depression in adolescent mothers and the implementation of health services and obstacles in dealing with postpartum depression in adolescent mothers.
Conclusion: Based on 7 articles reviewed, it was found that 32% of adolescent mothers have a chance of postpartum depression that requires immediate action on initial assessment, detection and intervention. Factors contributing to the development of postpartum depression in adolescent mothers include high social support, marital problems, pressure from parents and economic problems. Ongoing obstetric care, appropriate strategies and precautions including periodic screening for adolescent mothers and mental care providers are needed to reduce the risk of postpartum depression in adolescent mothers.
Recording: https://youtu.be/x2ko_70X4qY
Speaker: Arafin Happy Mim and Toma Ray
Facilitator: Margaret Aoro Adongo and Yosef Alemayehu Gebrehiwot
We are two young midwife leaders (23 years old) in Bangladesh who are board members of our midwives’ association (MA) and have recently graduated from an international leadership development programme. One works in a government health centre, the other in a Rohingya refugee camp. During 2022 we used quality improvement (QI) methodology to help our MA recruit and retain its members, and to develop guidance on responding to various types of emergency situations, which happen frequently in Bangladesh.
Discussion: MAs are examples of women-led civil-society organisations that can improve gender-equity and access to sexual and reproductive health rights, and act as agents for the profession (Mattison et al 2021). They have potential to impact each element of the ICM’s professional framework for midwifery. As midwifery is a new profession in Bangladesh, the midwives association (the Bangladesh Midwifery Society) is led by young women who are enthusiastic but inexperienced in organisational governance and leadership. A structured programme that taught us QI methodology was helpful for our leadership development, enabling us to drive change in our workplaces and in our MA.
Conclusions/Summary: We found it hard to apply QI methods to organisational development but we made it work. By sharing our lessons learned we hope to help other midwives and midwives’ associations understand how they can improve the quality of their services.
Reference: Mattison et al (2021) doi:10.1136/bmjgh-2020-004850
Recording: youtu.be/IcuXTEOj7WQ
Speakers: Heather Bradford and Jeremy Neal
Facilitator: Catherine Salam
Healthcare providers’ weight bias has been associated with negative patient interactions and poor quality of care. This dissertation is the first to measure weight bias among midwives and determine if the weight bias scores differ from other health professionals and the U.S. public. A research study was conducted which involved electronically surveying AMCB-certified midwives during the 2022 ACNM Annual Meeting and via email. Preliminary findings reveal that AMCB-certified midwives have a preference for people with underweight or normal body weights. The findings may inform future studies to determine if there is an association between perinatal providers’ weight bias and clinical decision-making, quality of care, and perinatal outcomes such as cesarean birth rates among birthing persons with higher body weights.
Recording: https://youtu.be/L-TScIK_7A0
Speaker: Lucia Monetta
Facilitator: Susana Ku
In 2020, our Argentina Midwifery Association launched a pilot program to develop a committee to strengthen two areas that have been less explored in our profession: research and leadership.
With the group of 4 young midwives, this committee developed a purpose, objetives and structure that will allow argentinian midwives to develop skills that will equip them to make a visible impact on their communities, by positioning midwifery in the Research Health field and to take on leadership roles in the Health Care Systems and organizations that tackle Sexual, Reproductive, Maternal & Newborn Health injustices and inequities.
From this initiative, several program were born: internships/mentoring program, educational programs in research studies, conferences, seminars and one of the biggest accomplishments: a registered Midwifery Journal.
The leadership program has grown over the past three years, achieving important leadership roles, mentoring midwives, as well as, more publishing and research opportunities.
The Midwifery Journal “OBSTETRIX” continues to grow with more collaborations, more midwives publishing their research work from central, Latin America, and more than two thousand subscribers.
In this presentation, we want to encourage midwives to initiate this kind of programs and innovation to develop in their countries. We would like to explore the experiences and opportunities and that can be achieved by working with a unique working environment that allows midwives to develop their full potential and the lessons learned throughout this program.
Recording: https://youtu.be/vC2DOEfLsLQ
Speaker: Amy Goh, Dia Kapoor, and Anna Nguyen
Facilitator: Olajumoke Ojeleye
Asians and Asian Americans (Asians) have the second highest rate of caesarean birth in the U.S. Asians have the lowest rate of out-of-hospital birth and are low utilizers of midwifery care. This presentation examines cesarean birth amongst Asians who have birthed at U.S. institutions participating in the AABC’s Perinatal Data Registry (PDR).
Methods: Data from the PDR from 2007-2020 was utilized. Logistical regression was completed to determine the odds of cesarean birth for nulliparous and multiparous Asians in medically low-risk and elective hospitals categories.
Results: 2,983 Asian birthing people were sampled. Multiparous birthing people had 1.5 greater odds of caesarean birth compared to nulliparous birthing people (OR = 1.54; 95% CI, 1.19 – 2.03; p .01). The elective hospitalization group had higher adjusted odds of caesarean births compared to the low-risk and total population (OR = 1.54; 95% CI, 1.23 -1.93; p; .01). Nulliparous people in the elective hospitalization category had a rate of caesarean birth 1.5 times higher than the total (OR = 1.26; 95% CI, 1.09 -1.46; p .01) and 1.36 times higher than the low-risk sample (OR = 1.36; 95% CI, 1.13 -1.63; p .01).
Conclusion: This study highlights inequities in multiparous and nulliparous cesarean birth among medically low-risk Asians. Further research is needed in disaggregation of perinatal outcomes and on reasons for low utilization of midwifery care and out-of-hospital births amongst U.S. Asians.
Recording: https://youtu.be/jc1ZxhkUvrc
Speaker: Erin Hanlon
Facilitator: Cecilia Jevitt and Akusmayra Ambarwati(Shadow)
Abstract:
Since 1990, New Zealand midwives have been privileged to elect to work within tertiary or primary health settings, employed, self-employed (case-loading), or a hybrid variation of both. However, despite the availability of midwife-led care, the local home birth rate has not substantially increased nor have medical interventions decreased, despite having a continuity of care. Narrative Inquiry methodology and methods were used to investigate the changes in the birthing culture in New Zealand from 1990 to today. The elements of temporality (time), sociality (social context), and place were borrowed from Connelly and Clandinin (2006) to collect and analyze stories from midwives and consumer participants nationally. This presentation initially maps the history of midwives gaining autonomy in New Zealand, then explores the experiences of midwives who spoke about a transition in their clinical practice from working within a highly medicalised model across the spectrum to attend home births. These hospital-trained midwives’ shared their stories of how performing highly technological services in labour instilled fears around birth. Participants discussed that in order to become home birth midwives, they needed to unlearn and then relearn the skills required to attend women birthing at home. Using temporality and sociality contextualized their accounts, as participants shared their experiences of how they discovered what birth ‘could be’ with less interference, which separated them apart from the dominant medicalised culture surrounding birth. As they relayed their stories around their relearning, they expressed a collegiality with other practitioners, and supportive, trusted relationships with women.
Recording: https://youtu.be/cG21rLXEzmo
Speaker: Linda Deys
Facilitator: Liz McNeill
Abstract:
The problem: Obstetric violence creates visions of a brutal and purposeful assault, however more covert practices cause similar psychological harm, are less understood, and more likely to be disregarded. Separating women from their well-baby at a caesarean section birth can cause long-lasting trauma. Method: A feminist phenomenological study, using birthing theories to understand the experience of women separated from their baby at caesarean section birth without a medical indication. Results: We identified four main themes that were interlinked: Disconnection, Emotional Turmoil, Insight and Influence. This presentation expands on Influence and the sub-themes of power & control, maternal choice & consent, coercion and staff actions. While obstetric violence was perceived with the physically forceful actions that some of these women experienced, it also showed more insidious events which caused comparable traumatic responses. The term ‘obstetric neglect’ was coined to symbolise maternity care where maternal choice and consent was voided by health care providers using power, control and coercion that influenced participant birth outcomes and experience. Conclusion: Birthing in an operating theatre environment limited the capacity of the participants to bodily autonomy and this vulnerability was not accounted for with woman-centred care. Midwifery training and values align with the need for the protection of, and advocacy for, women. These findings demonstrate the importance of a respectful, empowering and supportive midwifery contribution through every pregnancy and birth, in the development of policies and procedures, done in partnership with women.
Recording: https://youtu.be/bCUeuCB2cLU
Speaker: Arafin Happy Mim
Facilitators:Raissa Manika Purwaningtias & Constance Odonkor(shadow)
Abstract:
I am Mim, a Young Midwife Leader from Bangladesh. One year ago, I assumed the role of supervisor of midwives on Basanchar, a remote island near Hatiya Upazilla, Bangladesh, catering to 32,574 people and 7899 families, many of whom were Rohingya refugees relocated from Coxs Bazar. The island faces numerous health challenges, especially for women and children, with limited access to medical facilities, requiring Navy Frigate transportation twice weekly. Upon arrival, I encountered midwives lacking confidence and support in their practice. As the first midwife supervisor, doubts surrounded my leadership abilities, compounded by the democratic system’s challenges. Despite skepticism, I prioritized listening, reflection, and evidence-based advocacy to empower midwives and amplify their voices. Through collaborative efforts, we transformed the team, nurturing leadership skills and expanding their scope of practice. With a multidisciplinary approach, we now offer comprehensive sexual and reproductive health services and manage most complications locally, minimizing the need for external transfers. Looking ahead, our focus is on community awareness, affirming the pivotal role of midwives, and ensuring their practice aligns with standards. Continued education and research will further enhance our contributions to midwifery in Bangladesh, fostering a culture of quality care and acceptance in Basanchar.
Recording: https://youtu.be/_PO0Pisbxww
