Speaker: Jade Qiong Zheng
Facilitator: Jane Houston
Stillbirth is a unique phenomenon with various manifestations influenced by culture and spirituality. Different cultural and religious beliefs may influence the emotional response to perinatal grief as well as the demand for bereavement care. The majority existing research on perinatal grief comes from Western society. Under Chinese cultural context, post-stillbirth grief healing for bereaved mothers is not applicable.
Objective: This study investigated the role of culture and spirituality in the grief healing of mothers with stillbirth in China.
Methods: The study was grounded in an interpretivist constructionist epistemology. In-depth interviews with mothers suffering stillbirth within the previous year were used in a qualitative study. Thematic analysis was used to analyze the data.
Findings: 28 women were interviewed by trained interviewers. Three key themes were identified: 1. The impact of culture on grief expression with four sub-themes: Restrained expressions of grief, Unattainable mourning ceremony, Hospital policy as a barrier, and Others-oriented grief; 2. Cultural characteristics of post-stillbirth experiences with four sub-themes: The paternalistic medical culture, “KongYuezi”, The embarrassment of postpartum visiting， and Cultural taboos on dealing with deceased babies remains; 3.Significance in cultural and spiritual healing behaviour with four sub-themes: Finding the meaning of the event, Accepting and Reconciling with the event, Reshaping beliefs and worldviews of life and death, and Gaining and self-growth.
Conclusion: Culture and spirituality play an important role in bereaved mothers’ post-stillbirth grief healing. Caregivers should avoid preconceived notions about grief. A bereavement care guideline that is culturally and spiritually appropriate for China is required.
Recording: https://youtu.be/eDXegqWbIHk
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: 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
Speakers: Billie Bradford and Margaret Murphy
Facilitator: Meron Tessema
Abstract:
An estimated 2 million babies are stillborn at or before the time of their birth and 2 million babies die in the first month of life each year around the world. The International Stillbirth Alliance (ISA) is a global organization, aimed at ending preventable stillbirths and neonatal deaths via collaborations with researchers, clinicians and parent advocates. As midwives are key providers of pregnancy and perinatal healthcare globally there is the potential to advance the aims of ending preventable perinatal deaths and improving support and care of bereaved parents through collaboration between ISA and the global midwifery community. To enable this ISA has launched its Health Provider Advocacy and Parent Advocacy toolkits which are readily adaptable to different country settings and easily utilised by midwives globally. The Health Provider Advocacy toolkit provides information for midwives wanting to improve their skills in achieving deeper and more open communication with parents after a stillbirth by providing respectful bereavement care. The toolkit includes suggestions on ways to approach delivering the news, acknowledging parents’ grief, talking with parents about how and why their baby may have died, making room for them to express their need for support, and discussing a safe plan for future pregnancies. This presentation will provide an overview of the outputs developed by the International Stillbirth Alliance to support healthcare providers including the toolkits, the Global Guide for Stillbirth Advocacy and Implementation supported by the Gates Foundation, and resources available through our Western Pacific Regional Office the Stillbirth Centre of Research Excellence.
Recording: https://youtu.be/kAAXRbw01IY
Speakers: Cindy Farley, Jo Lethermon and Emily Western
Facilitators: Ally Anderson & Kinanthi Lebdawicaksaputri(shadow)
Abstract:
Moxibustion refers to the practice of burning the herb “moxa”- mugwort or Artemistae argyi – for its health properties. This practice originated from traditional Chinese medicine. Its most common use in childbearing populations is to assist in turning a breech presenting fetus to vertex prior to labor. This practice has an abundance of evidence attesting to its effectiveness with limited or no harm, and yet it is not often used, in part, due to providers’ lack of understanding. Hypnobirthing is a set of techniques that aim to give women and birthing people a more serene and joyful birthing experience by minimizing the pain and stress commonly associated with labor. Hypnobirthing involves training related to physiologic birth processes, relaxation techniques, self-hypnosis, visualization, light touch, and breathwork. It is taught in classes or workshops and can be supplemented with audio recordings and reading materials. It does not guarantee a completely pain-free labor, however, studies show that many women who use hypnobirthing techniques report having a less painful and more positive birthing experience. Sustaining midwifery mastery of alternative and complementary therapies that provide options to our patients requires education and support. Two Georgetown midwifery students will share the latest information about these therapies in the 9th annual Georgetown University Student Café at the VIDM. Integrative therapies offer a more wholistic approach to health care that combines techniques from several disciplines to be used in lieu of or in conjunction with medical treatments depending on the conditions and patient preference.
Recording: https://youtu.be/JCJzjLVHoN8
