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
Speaker: Belle Bruce
Facilitator: Louela Cordova-Acedara
Abstract:
Background: There is a major research gap relating to the impact of intravenous (IV) fluids administration during labour on maternal and neonatal outcomes. It is biologically plausible that a relationship between volume of IV fluids and primary postpartum haemorrhage (PPH) exists. Aim: To investigate the relationship between intrapartum IV fluids and PPH. Methods: A retrospective cohort study was conducted in a tertiary hospital from September 2021 to September 2022. Inclusion criteria were singleton pregnancy, planning a vaginal birth, and admitted for labour and birth care between 37-42 weeks gestation. The study factor was IV fluids during labour. The primary outcome was primary PPH. Birth and postnatal data were obtained from the electronic medical records and paper fluid order documentation. Secondary outcomes included caesarean section and neonatal weight loss following birth. Results: 1023 participants were included of which 339 had a PPH (33.1%). Our main finding was that there was no association between high-volume IV fluids (≥2.5L) and PPH after adjusting for demographic and clinical factors (ORadj1.02 CI: 0.72, 1.44). However, there was a positive association between high-volume IV fluids and caesarean section (ORadj 1.99; CI: 1.4, 2.8) and neonatal weight loss (ORadj 1.8; CI: 1.09, 2.0). Conclusions: These findings are important to further knowledge relating to the administration of IV fluids in labour and the potential impact of this common practice. It identifies future research priorities around documentation of IV fluids and their relationship with pregnancy and perinatal outcomes.
Recording: https://youtu.be/sjOijsnYkWM
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
