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: Rizka Ayu Setyani
Facilitator: Adetoro Adegoke
Maternal and child health is a critical public health priority in Indonesia; however, fragmented healthcare delivery and inequitable access to services continue to hinder optimal outcomes. This study evaluates the effectiveness of an integrated primary health service model in improving maternal and child health outcomes, focusing on midwives as central agents connecting healthcare systems, communities, and families.
A mixed-methods approach was employed across 10 primary healthcare facilities in urban and rural Indonesia. Quantitative data from patient records and service utilization statistics were analyzed, complemented by qualitative insights from interviews and focus group discussions with midwives, healthcare workers, and families.
The findings revealed a significant increase in antenatal and postnatal care visits (p 0.05) and improved continuity of care, including timely referrals and follow-ups. Midwives reported strengthened collaboration with community health workers and local facilities, while families highlighted better access to culturally responsive and holistic care. The introduction of digital tools further streamlined coordination and reduced delays in service delivery.
These results demonstrate that integrated primary health services can strengthen maternal and child healthcare systems, with midwives playing a pivotal role in bridging gaps and fostering trust. Scaling such models nationwide could enhance Safe Motherhood initiatives and accelerate progress toward achieving the Sustainable Development Goals.
Speaker: Carla Godoy
Facilitator: Susana Ku
Las parteras desempeñan un papel fundamental en la salud y el bienestar de nuestras comunidades, pero han enfrentan desafÃos como la falta de reconocimiento, apoyo institucional y oportunidades laborales. Es esencial fortalecer su rol, generar empleo y garantizar el respeto por su labor.
Más que un oficio, ser partera es una vocación que implica acompañar a las madres en momentos cruciales con profesionalismo y seguridad. Sin embargo, a pesar de su importancia histórica, muchas veces no reciben el reconocimiento que merecen. Para cambiar esta realidad, es clave impulsar oportunidades laborales en hospitales, clnicas y programas comunitarios de salud.
La solución pasa por la organización, la creación de redes de apoyo y la búsqueda de alianzas con el sector público y privado. Al unir fuerzas, es posible reducir el desempleo dentro de la comunidad de parteras y asegurar que su labor sea vista como indispensable para el bienestar social.
El camino hacia un mayor reconocimiento y estabilidad laboral requiere compromiso y trabajo conjunto. La unión de las parteras es su mayor fortaleza para lograr que su profesión sea valorada y esencial en la sociedad.
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Midwives play a fundamental role in the health and well-being of our communities, but they have faced challenges such as a lack of recognition, institutional support, and job opportunities. It is essential to strengthen their role, create jobs, and ensure respect for their work.
More than a profession, being a midwife is a vocation that involves accompanying mothers in crucial moments with professionalism and confidence. However, despite their historical importance, they often do not receive the recognition they deserve. To change this reality, it is key to promote job opportunities in hospitals, clinics, and community health programs.
The solution lies in organization, the creation of support networks, and the pursuit of partnerships with the public and private sectors. By joining forces, it is possible to reduce unemployment within the midwifery community and ensure that their work is seen as indispensable to social well-being.
The path to greater recognition and job stability requires commitment and collaborative work. The unity of midwives is their greatest strength in ensuring that their profession is valued and essential in society.
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Speakers: Marjolein Pijnappels and Susana Ku Carbonell
Facilitator: Catherine Salam
The Birth Future International Project explores innovative future scenarios for birth care, grounded in developments shaped by birthing communities and midwives as key agents of change. This study employs a qualitative method approach, integrating traditional participatory research methodologies with innovative, arts-based practices to guide participants through immersive processes of exploration and co-creation. Our cross-cultural sampling includes midwives from the Netherlands and Peru 90 , alongside service users from India, offering diverse perspectives on the evolving dynamics of birth care.
Our data analysis is based on action research analysis. Preliminary data analysis has informed the development of a zine, which synthesizes participant contributions into an accessible, creative format. This zine unveils a transformative vision for birth care, such as different ways of developing perinatal technology (technology for autonomy, rather than control), the role of the community in which birth (care) is embedded, addressing systemic injustice and inequality in global north and south, midwives as educated birth advocates/portals for bridging new ways of (birth) care, those articulated through critical reflections on participants’ lived experiences and current practices. Participants then identified innovative, community-centered care models that emphasize equity, cultural responsiveness, and inclusivity. Furthermore, the preliminary findings underscore the potential of participatory, arts-based research to amplify underrepresented voices and foster critical discourse on the future of maternal and newborn care.
By integrating interdisciplinary methodologies and global perspectives, this study contributes to the growing body of literature on the co-creation of equitable, humane, and sustainable birth care practices.
