Facilitator: Jane Houston
Join us at this pre-conference event with colleagues from the World Health Organization (WHO) celebrating the worldwide contribution of midwives.
Welcome and introduction from the World Health Organization (WHO) by Frida Berg with video greetings from
- Chief Nursing Officer: Dr Amelia Latu Afuhaamango Tuipulotu
- Director General: Dr Tedros Ghebreyesus
We will then explore the following topics:
- Evidence to reality in 6 countries, strategic findings (Clara Fischer and Prof. Lorena Binfa)
- Evidence to reality – From STAGE – recommendations on midwifery and how to take this forward (Justine Le Lez)
- Essential Childbirth care course and the Interprofessional Midwifery Education Toolkit (Dr Florence West and Indie Kaur)
- What’s new in WHO? (Dr Emily McWhirter)
Following a Question and Answer period, Dr Anshu Banerjee will provide closing remarks from WHO.
Recording: https://www.youtube.com/watch?v=6OAqCOOGfz0
Speaker: Elisabeth (Lizi) Jones
Facilitator: Caitlin Goodwin
Indigenous peoples and others living in Alaska and the circumpolar north are geographically remote and face climate conditions that can be extreme. They live in close connection to their environment and have developed characteristics of hardiness and resilience in the face of global pressures such as climate change and colonialism. Long-standing cultural traditions influence birth practices and expectations and are valuable to maintaining a shared sense of connection and caring for one another in these remote communities. Temporary relocation for childbirth has deleterious social effects and there is considerable support for traditional communal birthing in combination with modern techniques and technology. This presentation will describe a selection of Alaska Native and circumpolar childbirth traditions and outcomes, as well as the importance of birth in cultural continuity. Consideration will be given to the preservation of traditions and reflection on one’s own cultural humility and sensitivity, the value of incorporating ancient ways of knowing into modern medical practice, and the importance of promoting sovereignty and reclamation of birth by indigenous midwives worldwide. This presentation draws from a student assignment called “Celebrating Diversity in Childbirth” and is the 8th Annual Georgetown University Midwifery Student Café at the VIDM.
Recording: https://youtu.be/F6hXGnr4pP4
Speaker: Fatimah Siti and Andari Wari Astudi
Facilitator: Belle Bruce
Marriage and pregnancy in adolescence affect the health, financial and educational status of adolescents. Pregnancy in adolescence also creates stigma and negative issues in society and families. This Scoping review aims to find out the latest evidence based on the experience of adolescents who early marriage in decision making during pregnancy and childbirth.
The method used in this scoping review refers to the framework of Arkshey and O’malley and is documented into the PRISMA Flow Chart. Research article search strategies used include using inclusion and exclusion criteria, using MeSH (medical subject heading), truncation and boolean operators. The databases used include Pubmed, Sciencedirect, Proquest, EBSCO, and Wiley Online Library and also use grey Literature such as Google Scholar.
From 2,134 articles, the initial search found 9 articles that are eligible for a thorough review and resulted in 4 main themes, namely the decision-making process during pregnancy and childbirth, factors affecting decision-making during pregnancy and childbirth, forms of support in decision-making and expectations in decision-making during pregnancy and childbirth.
From the review of articles conducted, it is known that most teenagers lose autonomy in decision making because it is often done by older family members and is considered more experienced. The existence of programs and/ education related to adolescent health using gender and cultural approaches is expected to increase participation and role in decision making.
Recording: https://youtu.be/cmj5HN8i_ss
Title: Professional Midwifery: Revolutionising Maternal Care in India
Speaker: Indie Kaur
Facilitators: Red Miller and Suman Lata
Research shows that midwife-led care reduces unnecessary interventions, and mothers go on to have better birth experiences. In 2011, Fernandez Hospital piloted an in-house professional midwifery education and training program when such a cadre did not exist in India. Unnecessary interventions like episiotomies and epidurals decreased, and women’s positive feedback increased yearly. Looking at this success, the Government of Telangana and UNICEF partnered with Fernandez Hospital to pilot midwifery training in its public hospitals.
These midwives created a paradigm shift in maternity care, helped increase normal births, and promoted respectful maternity care in the state’s public facilities. This led to the government investing in the need for separate training for midwives in India and launching ‘Guidelines on Midwifery Services’ in 2018. This was a historic moment for midwifery in the country, recognising the need for a separate professional training building on a strong cadre and rolling our midwifery care to women and new-born in the country.
The Foundation has since partnered with The Government of India and Telangana State with the support of The World Health Organisation (WHO) and UNICEF to train midwifery educators in India, strengthening midwifery services.
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: Yasmin Rose
Facilitator: Caroline Cherotich Bii
This lecture will walk through the journey of the cord blood from the moment a baby is born, what purpose it serves and why it is paramount babies receive the full amount of blood. The cord blood not only increases the volume of the blood, but is instrumental in setting up the lungs properly. We will look at the difference between fetus circulation and newborn circulation, the difference between waterborn babies and land born babies, and understand why 1 minute cord-clamping is not sufficient. The aim is to achieve optimal cord clamping for every birth.
Recording: https://youtu.be/wVhJ9z3UEsA
Speaker: Ponsiano Kabakyenga Nuwagaba
Facilitator: Hayat Gommaa
In low- and middle-income countries, several barriers impede utilisation of antenatal care (ANC) services by women with disabilities, yet ANC is a critical entry point for pregnant women to receive quality maternity care services. We investigated the experiences of pregnant women with physical disabilities in utilising ANC services to suggest strategies for improving the services.
Methods: A qualitative study using a multiple case study design was conducted. Twelve women with physical disabilities and six midwives from three health facilities in Sheema District in rural south-western Uganda, were selected as study participants. Women were sampled using snowball sampling. Midwives and health facilities were sampled using purposive sampling. Data was gathered through face-to-face interviews and a focus group discussion between November 2020 to January 2021. Data was transcribed, translated and thematically analysed. Ethical approval was obtained from University of Cape Town and Uganda National Council for Science and Technology. No competing interests declared.
Results: Women had mixed experiences of midwives and other health workers, noting that sometimes midwives would be supportive and other times, they would be unapproachable. Participants felt that midwives had limited knowledge on disability and were emotionally unprepared to attend to pregnant women with disabilities. There were suggestions for disability inclusion, including a dedicated ANC clinic and making connections with stakeholders, for fit-for-purpose ANC services.
Conclusion: Midwives have limited understanding of the implications of physical disability on women’s utilisation of ANC services. Respect for women with disabilities’ dignity and needs should be emphasized in midwifery education and training.
Recording: youtube.com/watch?v=ihQOrbHdI2M
Speaker: Tom McEwan and Moira Lewitt
Facilitator: Adetoro Adegoke
Respectful of ‘artistry’ within midwifery, a recent research study conducted with Professor Moira Lewitt explored how midwifery students understand the concept of professionalism and how their professional identity develops during midwifery education. Midwifery students learn and adopt complex professional behaviours in a variety of academic and clinical settings throughout their educational journey. The aims of this study were to explore how midwifery students understand the concept of professionalism and how their professional identity develops during midwifery education.. The method used a conversation about professionalism with a group of final year midwifery students that was transcribed ‘in the moment’ and immediately performed to the group as poetry. Themes emerging from analysis of the conversation are also presented as poetry. The results demonstrated that midwifery students, moving between university and practice, emphasise the importance of close connections between these spaces and the role models in them, for learning. External constraints generated a sense of fear and stress that was seen to limit midwives’ ability to properly support the needs of ‘their woman’. We concluded that the notion of ‘spaces’ is important in maternity care and developing education for future midwives. Poetry is a useful multidimensional tool in research. This utilised poetry as an innovative multidimensional tool for research. The process of conducting this research, the key themes identified and the poetry generated will be discussed in this session.
Recording: https://youtu.be/nglnqbG26vs
Speaker: Arafin Happy Mim and Toma Ray
Facilitator: Margaret Aoro Adongo and Yosef Alemayehu Gebrehiwot
We are two young midwife leaders (23 years old) in Bangladesh who are board members of our midwives’ association (MA) and have recently graduated from an international leadership development programme. One works in a government health centre, the other in a Rohingya refugee camp. During 2022 we used quality improvement (QI) methodology to help our MA recruit and retain its members, and to develop guidance on responding to various types of emergency situations, which happen frequently in Bangladesh.
Discussion: MAs are examples of women-led civil-society organisations that can improve gender-equity and access to sexual and reproductive health rights, and act as agents for the profession (Mattison et al 2021). They have potential to impact each element of the ICM’s professional framework for midwifery. As midwifery is a new profession in Bangladesh, the midwives association (the Bangladesh Midwifery Society) is led by young women who are enthusiastic but inexperienced in organisational governance and leadership. A structured programme that taught us QI methodology was helpful for our leadership development, enabling us to drive change in our workplaces and in our MA.
Conclusions/Summary: We found it hard to apply QI methods to organisational development but we made it work. By sharing our lessons learned we hope to help other midwives and midwives’ associations understand how they can improve the quality of their services.
Reference: Mattison et al (2021) doi:10.1136/bmjgh-2020-004850
Recording: youtu.be/IcuXTEOj7WQ
Speaker: Paloma Terra and Maria do Perpétuo Socorro da Silva Rodrigues
Facilitator: Susana Ku
This presentation will be based on the research project Midwives of the Brazilian Amazon by Paloma Terra funded by Huron University of Canada. The project uses Critical and Decolonial research methodology and did interviews with Traditional Midwives of the Brazilian upper Amazon Region. This discussion will be a joint presentation in Portuguese with Maria do Socorro who is the president of the Midwifery Association Algodão Roxo a Traditional Midwives Association of the State of Amazonas. We will discuss the place of Traditional Midwifery in the modern world and why it is important to work to preserve and strengthen it. Socorro will present in Portuguese the history of the formation of the Association and their current work and struggles. Paloma will share some of the main take aways from the research project in both English and Portuguese.
Recording: https://youtu.be/RQco_ouNrCU
Speaker: Amy Goh, Dia Kapoor, and Anna Nguyen
Facilitator: Olajumoke Ojeleye
Asians and Asian Americans (Asians) have the second highest rate of caesarean birth in the U.S. Asians have the lowest rate of out-of-hospital birth and are low utilizers of midwifery care. This presentation examines cesarean birth amongst Asians who have birthed at U.S. institutions participating in the AABC’s Perinatal Data Registry (PDR).
Methods: Data from the PDR from 2007-2020 was utilized. Logistical regression was completed to determine the odds of cesarean birth for nulliparous and multiparous Asians in medically low-risk and elective hospitals categories.
Results: 2,983 Asian birthing people were sampled. Multiparous birthing people had 1.5 greater odds of caesarean birth compared to nulliparous birthing people (OR = 1.54; 95% CI, 1.19 – 2.03; p .01). The elective hospitalization group had higher adjusted odds of caesarean births compared to the low-risk and total population (OR = 1.54; 95% CI, 1.23 -1.93; p; .01). Nulliparous people in the elective hospitalization category had a rate of caesarean birth 1.5 times higher than the total (OR = 1.26; 95% CI, 1.09 -1.46; p .01) and 1.36 times higher than the low-risk sample (OR = 1.36; 95% CI, 1.13 -1.63; p .01).
Conclusion: This study highlights inequities in multiparous and nulliparous cesarean birth among medically low-risk Asians. Further research is needed in disaggregation of perinatal outcomes and on reasons for low utilization of midwifery care and out-of-hospital births amongst U.S. Asians.
Recording: https://youtu.be/jc1ZxhkUvrc
Speaker: Lesley Pascuzzi
Facilitator: Catherine Salam
Abstract:
The journey to parenthood is a time of significant change. For most, pregnancy is a time of great joy. However, this period can be associated with an increase in mental health difficulty. In Australia, it is estimated that 1 in 5 mothers and 1 in 10 partners will experience perinatal anxiety and depression with an estimated national cost of $877m annually. There is well established screening for risk of perinatal mental illness during routine maternity care in both public and in some private hospitals using the Edinburgh Postnatal Depression Scale. As defined by World Health Organization (WHO), complete health is “physical, mental and social wellbeing, not merely the absence of disease or infirmity”. Routine practice within maternity care at present, offers women physical screening to detect pathology and disease but has no standardized screening for promotion of mental health and emotional wellbeing. Informed by the current “detect disease” orientation of maternity care, Australian women screened by a midwife to be without risk for mental illness, are perceived to be emotionally well in the absence of a clear definition of what it means to be emotionally well. In everyday maternity healthcare, this presents an opportunity lost for midwives to have meaningful conversations with women to align with the sustainable midwifery practice of prioritizing the holistic wellbeing of the mother first and foremost. This presentation will share the findings of a scoping review to explore the needs and barriers facing midwives to work to their full scope of practice in this area.
Recording: https://youtu.be/6xkJlS4APDk
Speaker: Erin Hanlon
Facilitator: Cecilia Jevitt and Akusmayra Ambarwati(Shadow)
Abstract:
Since 1990, New Zealand midwives have been privileged to elect to work within tertiary or primary health settings, employed, self-employed (case-loading), or a hybrid variation of both. However, despite the availability of midwife-led care, the local home birth rate has not substantially increased nor have medical interventions decreased, despite having a continuity of care. Narrative Inquiry methodology and methods were used to investigate the changes in the birthing culture in New Zealand from 1990 to today. The elements of temporality (time), sociality (social context), and place were borrowed from Connelly and Clandinin (2006) to collect and analyze stories from midwives and consumer participants nationally. This presentation initially maps the history of midwives gaining autonomy in New Zealand, then explores the experiences of midwives who spoke about a transition in their clinical practice from working within a highly medicalised model across the spectrum to attend home births. These hospital-trained midwives’ shared their stories of how performing highly technological services in labour instilled fears around birth. Participants discussed that in order to become home birth midwives, they needed to unlearn and then relearn the skills required to attend women birthing at home. Using temporality and sociality contextualized their accounts, as participants shared their experiences of how they discovered what birth ‘could be’ with less interference, which separated them apart from the dominant medicalised culture surrounding birth. As they relayed their stories around their relearning, they expressed a collegiality with other practitioners, and supportive, trusted relationships with women.
Recording: https://youtu.be/cG21rLXEzmo
Speaker: Ally Anderson
Facilitator(s): Kate Frith
Abstract:
Background: Midwives are the foundation to reducing maternal and neonatal mortality. Midwives facilitate physiological birth processes to support and enable women to have an optimal birth. Maternity care in the Czech Republic is obstetric led, medicalised and patriarchal. The Midwifery Unit Network collaborated with a Czech hospital to provide training for midwives on optimal birth techniques as part of a wider initiative to develop the first midwife-led unit in Prague. Aim: To explore the facilitators and barriers for implementing the learning objectives of a bespoke ‘Optimal Birth’ Programme into practice in a state hospital in Prague, Czech Republic. Method: A qualitative descriptive phenomenological approach was followed. Purposive sampling was used to select nine participants who met the selection criteria, were willing to participate, and signed the consent form. Data collection was via two participation observations and semi-structured interviews. Thematic analysis was carried out on the data retrieved. Results: Six main themes emerged: politics and society, organisational culture, supporting physiology, models of care and technology use, resources to support practice shift and supporting the practice shift. Discussion: Many facilitators and barriers were discussed, ranging from the political and organisational level to the funding and resources available and the confidence of the individual practitioners.
Recording: https://youtu.be/VUdhypSe8B4
