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.
Speaker: Red Miller
Facilitator: Linda Deys
As a home birth midwife with nearly 2 decades of experience working the continuity of care model, I have found the word that most relates to my practice style is Biodynamic Midwifery. In my practice, I also have a strong focus on addressing fears to create space for ultimate outcomes.
Fear exploration is such an essential process for the birthing women and also the birthing partner, the older sibling, the grandparents, the doulas, whoever will be present and surrounding the mother at the time of birth.
This presentation will explore:
- the word biodynamic and introduce the concept of biodynamic midwifery.
- An introduction to the concept of relational field dynamics and explore how to hold a field of integrity and trust.
- An exploration of the role we carry as midwives to help shift a family from fear to love, including practical, applicable tools for self-exploration as well as for use with the families. We will explore how this practice is the fastest way to return a mother to their intuition.
I want to leave the participants with a renewed sense of passion for this sacred work and give them new ways of BEING within it!
