Onwards and upwards. Turning a pandemic into midwifery opportunities
Speaker: Sarah Stewart
Facilitator: Deborah Davis
Fifteen years ago I started the Virtual International Day of the Midwife (VIDM) on my kitchen table. The first year I pretty much spent talking to myself. Who could have guessed all these years later that a global pandemic, which would cause such devastation, would also make virtual conferencing an everyday occurrence. And that the organising committee could leverage COVID-19 into an opportunity to grow the VIDM to an audience of thousands across the world. In this presentation I will be reflecting on the lessons I learned over the years I was facilitating the VIDM about leadership, collaboration and innovation which are critical elements we need to influence and shape midwifery and women/people-centred care as we transition out of the pandemic.
Recording: https://youtu.be/TeuD1XwAEU0
Title: Arte de la Partería Indígena: Resistencias, desafíos y continuidades
Speaker: Tania Pariona Tarqui
Facilitator: Paloma Terra
Los objetivos de este mapeo son: identificar organizaciones de parteras indígenas, además de delinear la situación en la que se encuentran y las experiencias que se han generado cada país, acorde a su contexto histórico y aspectos legales. Finalmente, indicar las buenas prácticas, recomendaciones y retos señalados por las organizaciones de parteras de cada país.
Uno de los elementos relevantes del mapeo, es las diferencias que existen entre el ejercicio de la partería y la relación con el Estado, esto de acuerdo al nivel organizativo alcanzado por los grupos de parteras y los avances legales en el reconocimiento de la misma. Por ejemplo, algunas parteras en sus países presentan un estado de sobrevivencia por el poco o nulo reconocimiento de los pueblos originarios y la partería indígena, en otros casos por su nivel de organización hay parteras indígenas que en sus países exigen autonomía al Estado.
Sin embargo, en todos los países se dan prácticas de control, desprestigio y criminalización. Esto realza la importancia de fortalecer las organizaciones de parteras y de los pueblos originarios para la construcción de propuestas desde los sistemas de salud indígenas y la articulación horizontal con los Estados.
Como parte de sus recomendaciones se destaca la necesidad de fortalecer el tejido organizativo entre las parteras tanto a nivel nacional como en la región, el politizar la lucha por el respeto a las parteras y todas las mujeres como sujetos de derechos para que puedan tomar decisiones informadas sobre su cuerpo, su maternidad y la atención del parto desde su propia tradición y la necesidad del cuidado de las abuelas parteras que viven en situaciones vulnerables como garante de la continuidad generacional para el cuidado de las mujeres y comunidades de los pueblos indígenas.
Recording: https://youtu.be/zuIlj3va4E4
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
Title: When art and science collide: towards a political philosophy of humanised birth
Speaker: Elizabeth Newnham
Facilitator: Red Miller
In this presentation I draw together the various threads of my work to propose a political philosophy of birth space and practice. I first examine how the ‘science’ (of knowledge production) affects the ‘art’ (of midwifery practice) using the example of epidural analgesia, water immersion and constructions of ‘safety’ in obstetric discourse. From this, I introduce the conceptual framework of the ‘institutional paradox’ – the framing of particular practices as safe or risky, the effects of ‘institutional momentum’, and the precarious positioning of midwives as ‘guardians of normal’ within a system that views birth as, at best, risky, at worst, pathological. I then show how the influence of this institutional paradox leads to a form of rhetorical informed consent that enables dehumanising birth practices, before using the lens of care ethics to turn to the work of humanising birth, with a focus on relationality and the concept of attentiveness.
Recording: https://youtu.be/AshmJUtO7nI
Title: Biomechanics for birth: New learning & insights for practice: The 3 R’s
Speaker: Molly O’Brien
Facilitator: Linda Wylie
Midwifery work is wide ranging. In essence we are public health practitioners, protecting, maintaining and enhancing the health and wellbeing of women and their families. As skilled practitioners we seek to understand and mitigate myriad factors that contribute to ill health while aiming to support and optimise birth physiology as per our code of proficiency.
Specifically, the presentation focuses on labour dystocia and the midwifery skill of recognising when birth goes awry using the art and science of watchful attendance. It looks at ways to support physiology to reduce difficulties during the birth process and seeks to resolve mechanical difficulties by optimising physiology including the use of biomechanical techniques.
This presentation highlights areas of midwifery training and education that hinder understanding of anatomy and physiology in relation to the birth process and the baby’s journey through the pelvis. It examines the impact the dominant biomedical model of care has on midwifery practice, the profession as a whole and the women who use the service.
Recording: youtube.com/watch?v=FVN63zUtXXI
Title: Considering evidence and wisdom in professional reality
Speaker: Céline Lemay
Facilitator: Elisa Segoni
With EBM we also see a proliferation of guidelines and recommendations directed targeting practitioners that are expected to “apply” them and valuing a standardised care. In their daily practice midwives are facing two different important professional orientations: following guidelines/protocols and also providing a woman centered individualized care. How to take the most appropriate decision for the patient then? The reality is complex and often hold ethical tensions. How can we demonstrate a good quality of care? In past years there was a number of publications promoting the importance of more practical wisdom or “phronesis” in health care professional practice. A review of literature on the subject was undertook and 37 papers were selected to answer the main question: how can we understand the meaning of practical wisdom and its place for a good quality of healthcare? Can practical wisdom be learned, taught, developed and cultivated? We will develop the mean findings of our review, highlighting the fundamental place of professional judgement in the profession. It is a question of using discernment and deliberation to decide the best action for the good of a unique person in a context of care. There is also the valorisation of a reflexive practice in clinical places as well as using narratives of experiences to learn discussion and reflection during undergraduate period. In all context of care practical wisdom can help midwives to use the strengths of EBM AND have a woman centered care. It is seen as a mean to flourish as a professional.
Recording: https://youtu.be/Ir1AJXKZVQs
VIDM is not over yet! Following the closing Keynote speaker, stay right where you are for the closing events.
Facilitator: Lorraine Mockford
VIDM founder Sarah Stewart is back with a taste of her comedy routine: Donuts, Fireman Sam, and living with a hoarder!
Sarah Stewart is a midwife, nurse and stand up comedian. Sarah has performed comedy around Australia and is a member of the very successful comedy team, The Women’s Room, who have just had 2 sold out seasons at the Canberra Comedy Festival. Sarah has lots to say about being a wife, mother, getting old and of course….being a midwife. Sarah will be performing in her pyjamas, in bed, and feeling like a right wally because virtual comedy is weird. The good news for Sarah is if you heckle her, she can just mute you!
Then join the VIDM Organizing Committee, volunteers, and delegates as we say thank-you for another year by sharing our closing video with you.
Recording FINAL closing slideshow selfie photos – https://youtu.be/5r7DqvZ5or4
Title: Wombs and Wildfires: Community Based Maternal and Newborn Health and the Climate Crisis
Speakers: Skye Wheeler and Aver Yakubu
Facilitator(s): Isabella Garti and Ayele Bali (Shadow)
Abstract:
The climate crisis is the major public health crisis of our time. Pregnant people and newborns are especially vulnerable to the fossil-fuel driven disasters undermining communities across the globe, and a growing body of science points to associations between
climate impacts including extreme heat, wildfires, other disasters, and higher rates of poor maternal health including preterm birth, low birth weight and stillbirth. The session will provide an overview of some of the best academic science and community reporting
on the intersection of climate and maternal and newborn health and recent positioning on the issue by major international organizations, including UN agencies. Skye Wheeler, from Human Rights Watch, will provide insights into extreme heat in Pakistan and other
LMICs and why research is showing additional vulnerabilities associated with physical work and care work including mothering newborns and other children. She will also talk about why extreme heat is relevant to the Black maternal health crisis in the US. Aver
Yakubu, from Nuturely, will provide a deeper dive into wildfire impacts on maternal and newborn health and recent learnings from research in Oregon state, a highly wildfire-impacted state in the US. Both will discuss current best practices and thinking, what
more we need to learn, and why community-based and culturally competent care is so crucial as part of the way forward out of this crisis towards a more sustainable future.
Recording: https://youtu.be/5MjA6sxNxOk
Title: The Midwifery Sustainability Project: a strategic priority for the Association of Ontario Midwives
Speakers: Elizabeth Brandeis and Remi Ejiwunmi
Facilitator(s): Jane Houston
Abstract:
This presentation by ‘Remi Ejiwunmi, RM MSc, Chair of the Association of Ontario Midwives’ Midwifery Sustainability Project Steering Committee, and Elizabeth Brandeis, RM MSc, Staff Lead of the Midwifery Sustainability Project, will describe the trends and conditions in Ontario midwifery that are leading to unprecedented rates of burnout and attrition from the profession. The presentation will provide a brief overview of Ontario midwifery within a publicly funded model in which midwives work mainly in community-based, midwife-led practice groups and provide choice of birthplace including home and hospital birth, and in some communities, the option of free-standing birth centres. It will then explore the current state of midwifery and situate it within an evidence-based framework of the systemic factors that act as enablers or barriers to midwifery sustainability. The presentation will include a description of the first phase of the Midwifery Sustainability Project, the focus of which has been to understand the scope of the issue of sustainability for midwives. The presenters will then describe how the project will move from research to action to address the barriers to midwifery sustainability in Ontario.
Recording: Not available
