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: 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: Lucia Monetta
Facilitator: Susana Ku
In 2020, our Argentina Midwifery Association launched a pilot program to develop a committee to strengthen two areas that have been less explored in our profession: research and leadership.
With the group of 4 young midwives, this committee developed a purpose, objetives and structure that will allow argentinian midwives to develop skills that will equip them to make a visible impact on their communities, by positioning midwifery in the Research Health field and to take on leadership roles in the Health Care Systems and organizations that tackle Sexual, Reproductive, Maternal & Newborn Health injustices and inequities.
From this initiative, several program were born: internships/mentoring program, educational programs in research studies, conferences, seminars and one of the biggest accomplishments: a registered Midwifery Journal.
The leadership program has grown over the past three years, achieving important leadership roles, mentoring midwives, as well as, more publishing and research opportunities.
The Midwifery Journal “OBSTETRIX” continues to grow with more collaborations, more midwives publishing their research work from central, Latin America, and more than two thousand subscribers.
In this presentation, we want to encourage midwives to initiate this kind of programs and innovation to develop in their countries. We would like to explore the experiences and opportunities and that can be achieved by working with a unique working environment that allows midwives to develop their full potential and the lessons learned throughout this program.
Recording: https://youtu.be/vC2DOEfLsLQ
Speaker: Patricia Marianella
Facilitator: Paloma Terra
El objetivo fue comparar los resultados materno-neonatales y costos de la resolución de embarazos, en mujeres obesas y con peso normal pregestacional.
Métodos: Estudio transversal realizado en 60 gestantes con obesidad y 120 con peso normal pregestacional atendidas en un hospital público de Lima durante el 2018, seleccionadas aleatoriamente. Se recolectaron datos sociodemográficos, indicadores maternos (índice de masa corporal pregestacional, controles prenatales, edad gestacional, días de hospitalización), neonatales (Apgar, peso, morbilidad, edad gestacional por examen físico, días de hospitalización) y datos de los costos (medicamentos, procedimientos e insumos). Se utilizó la prueba estadística U de Mann Whitney.
Resultados: Se encontraron diferencias entre mujeres obesas y con peso normal pregestacional en los días de hospitalización materna (3 ±1,2 días vs 2,0 ±1,2 días; p=0,000); en el peso del recién nacido (3 615 ± 518,03 gr vs 3 245 ± 426,25 gr; p=0,000), en el costo de medicamentos ($ 19,78 ±16,47 vs $ 3,21 ±15,57; p=0,000), en el costo de procedimientos ($ 40,65 ±46,78 vs $ 27,67 ±49,47; p=0,001), y en el costo de insumos ($ 54,08 ±29,02 vs $ 9,32 ±28,26; p=0,000).
Conclusión: Las mujeres obesas presentaron recién nacidos con mayor peso, contaron con más días de hospitalización y los costos de medicamentos, procedimientos e insumos fueron superiores en comparación con las mujeres de peso normal.
English:
The objective was to compare maternal-neonatal outcomes and costs of pregnancy resolution in obese women and women with normal pregestational weight. Methods: Cross-sectional study conducted in 60 pregnant women, randomly selected, with obesity and 120 with normal pregestational weight attended in a public hospital in Lima during 2018. Sociodemographic data, maternal indicators (pregestational body mass index, prenatal controls, gestational age, days of hospitalization), neonatal (Apgar, weight, morbidity, gestational age by physical examination, days of hospitalization) and cost data (drugs, procedures and supplies) were collected. The Mann Whitney U statistical test was used. Results: Differences were found between obese and pregestational normal weight women in maternal hospitalization days (3 ±1.2 days vs. 2.0 ±1.2 days; p=0.000); in newborn weight (3 615 ± 518.03 gr vs. 3 245 ± 426.25 gr; p=0.000), in the cost of medications ($ 19.78 ±16.47 vs $ 3.21 ±15.57; p=0.000), in the cost of procedures ($ 40.65 ±46.78 vs $ 27.67 ±49.47; p=0.001), and in the cost of supplies ($ 54.08 ±29.02 vs $ 9.32 ±28.26; p=0.000).Conclusion: Obese women had heavier newborns, more days of hospitalization and the costs of medications, procedures and supplies were higher compared to women of normal weight.
Recording: https://youtu.be/McAV7M1Ub4M
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
Speaker: Arafin Happy Mim
Facilitators:Raissa Manika Purwaningtias & Constance Odonkor(shadow)
Abstract:
I am Mim, a Young Midwife Leader from Bangladesh. One year ago, I assumed the role of supervisor of midwives on Basanchar, a remote island near Hatiya Upazilla, Bangladesh, catering to 32,574 people and 7899 families, many of whom were Rohingya refugees relocated from Coxs Bazar. The island faces numerous health challenges, especially for women and children, with limited access to medical facilities, requiring Navy Frigate transportation twice weekly. Upon arrival, I encountered midwives lacking confidence and support in their practice. As the first midwife supervisor, doubts surrounded my leadership abilities, compounded by the democratic system’s challenges. Despite skepticism, I prioritized listening, reflection, and evidence-based advocacy to empower midwives and amplify their voices. Through collaborative efforts, we transformed the team, nurturing leadership skills and expanding their scope of practice. With a multidisciplinary approach, we now offer comprehensive sexual and reproductive health services and manage most complications locally, minimizing the need for external transfers. Looking ahead, our focus is on community awareness, affirming the pivotal role of midwives, and ensuring their practice aligns with standards. Continued education and research will further enhance our contributions to midwifery in Bangladesh, fostering a culture of quality care and acceptance in Basanchar.
Recording: https://youtu.be/_PO0Pisbxww
