Speaker: Melese Siyoum
Facilitator: Indri Astuti Purwanti
Back ground: Pelvic organ prolapse (POP) is a common condition that can significantly impact a woman’s quality of life. Pelvic floor muscle training (PFMT) is recommended as a first-line conservative treatment for prolapse, but evidence from low-resource settings is limited.
Objectives: This study aimed to assess midwife-led pelvic floor muscle training on prolapse symptoms and health-related quality of life (HRQoL) among women with mild to moderate prolapse in Ethiopia, 2024.
Methods: A community-based, parallel, two-arm cluster randomized controlled trial was conducted in Dale and Wonsho districts of Sidama Region, Ethiopia. Women with symptomatic POP stage I-III were randomized by cluster to receive either midwife-led PFMT plus lifestyle counseling (intervention group) or lifestyle counseling alone (control group). The primary outcomes were change in prolapse symptom score (POP-SS) and prolapse quality of life (P-QoL). Mixed-effects generalized linear model was used to determine the effect size at 99% confidence level.
Results: A total of 187 women were randomized (intervention = 89 and control = 98). At sixth month, the intervention group showed significantly greater improvements with a mean change difference of: -4.1 (99% CI: -5.38, -2.83) in prolapse symptoms; -11.48 (99% CI: -15.9, -7.1) in physical domain, -12.65 (99% CI: -19.3, -6.1) in psychological domain and -9.47 (99% CI: -15.5, -3.5) in personal relationship domain of P-QoL. A significantly higher number of women in the intervention group perceived their condition as ‘better’ after the intervention. Women with earlier stages of prolapse (stage I and II) experienced higher benefits compared to stage III.
Conclusions: A midwife-led PFMT combined with lifestyle counseling significantly improves prolapse symptoms and quality of life in mild to moderate POP. This strategy can be integrated into the existing maternal and reproductive health programs to address POP in low-income settings where access to trained specialist is limited.
Speakers: Rachael Ame Maima and Linda Deys
Facilitator: Caroline Maringa/Nyambura
Maternal and newborn mortality rates in Papua New Guinea are among the highest in the world, with around 170 deaths for every 100, 000 women and 20 neonatal deaths per 1000 live births each year. The causes for many of these deaths are preventable or treatable when women have equal access to safe, quality health care. Lack of midwives and resources increases the impact for remote communities but also for those living in cities such as Port Moresby.
In April 2024 the fourth group of the PNG Midwifery Leadership Buddy Project met in Port Moresby with 14 PNG and 7 Australian midwifery mentors, aiming to improve maternal and newborn outcomes in PNG. This twinning program of the PNG Midwifery Society and the Australian College of Midwives is funded by Rotary and informed by the ICM Member Association Capacity Assessment Tool (MACAT). PNG buddies identified quality improvement projects within their workplaces, with the Australian midwives supporting the development of leadership and advocacy skills for the projects to be completed.
This presentation will introduce one of the 2024 buddy relationships and project which aimed to increase the known haemoglobin level of women accessing antenatal care in a clinic in Port Moresby. It will describe the importance of a known Hb and demonstrate the processes, challenges, successes and setbacks experienced and highlight the importance of resilience and patience. It will emphasise how professional midwifery connections and mentorship can promote leadership, improve maternity outcomes, and strengthen the role of midwives across countries.
Speakers: Ronny Valenzuela, Vicki Penwell & Vijaya Krishnan
Facilitator: Adebukunola Olajumoke Afolabi
Collaboration is a cornerstone of effective, safe, and respectful maternity care. The International Childbirth Initiative framework centers the role of midwives in the provision of respectful care and creates a space to allow for increased understanding and promotion of midwifery across countries where midwifery has not been integrated. The goal of the Initiative is to promote practices that allow for safe physiological birth, including promotion of the midwifery philosophy and access to continuous support. The need for midwives is greater than ever as globally we observe a trend of increasing maternal mortality and sharply increasing rates of cesarean birth.
This panel will introduce the Initiative, with midwives speaking from participating health facilities in Chile, India, and the Philippines about their experiences of collaborating with their community, physicians, nurses, administrators, and policy makers through the Initiative’s platform.
