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
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: Alison Eddy and Carol Bartle
Facilitator(s): Catherine Salam (Izza Alifina)
Abstract:
Te Kāreti O Nga Kaiwhakawhanau Ki Aotearoa | The NZ College of Midwives and their college members are promoting midwifery action on climate change and working towards supporting national and global initiatives which reduce the negative impacts of climate change. Wherever they work midwives can consider the environment and identify ways to minimise their impact both personally and professionally. Small actions can grow into a significant movement and midwives can advocate for social change in relation to sustainability and healthy environments. The ‘fingerprint of climate change’ has been described as beginning before a baby is born due to pregnant women already enduring environmental crises that their children will be exposed to after birth.[1] This presentation tracks how an increased awareness of the impact of climate change sparked the College into action aimed at supporting some mitigation of climate change via a lens on midwifery practice related to pregnancy, birth, and infant feeding. The College recognises the potential for midwifery globally to develop a model of excellence for climate action and sustainability and we will present what we have achieved so far, and the steps we are taking towards collective action.
[1] Pacheco, S. (2020). Catastrophic effects of climate change on children’s health start before birth. The Journal of Clinical Investigation, 130(2),562-564.
Recording: https://youtu.be/LRidySKzuBU
Speakers: Fabella Elisa Cahyaningtyas and Zalfa Dinah
Facilitator: Caroline Maringa
Abstract:
Background: The increase in cesarean sections has occurred throughout the world, especially in developing and developed countries, over the last few decades and has led to increased research, debate, and concern among health professionals, governments, policymakers, scientists, and clinicians. So, to overcome the increasing number of cesarean sections, the VBAC technique was developed, namely vaginal birth for pregnant women who have had a history of cesarean sections in previous pregnancies. 90% of women who have a cesarean section are possible candidates for VBAC during a subsequent pregnancy. 60%–80% of them are able to give birth successfully vaginally. Mentoring is defined as the process of providing convenience to clients in identifying needs and solving problems, as well as encouraging the growth of initiative in the decision-making process, in this case, the decision to choose VBAC. So this study article aims to describe assistance for a successful VBAC. Case Report: Assistance for a 36-year-old pregnant woman with G4P2013 since 25/26 weeks of gestation at one of the PUSKESMAS in Surabaya. BSC 2x: history of a happy pregnancy in the first pregnancy and history of curettage abortion in the second pregnancy. The last child is 2 years old. Have the desire to give birth naturally. Mother had a successful VBAC without tearing on 7/7/2022 at 39/40 weeks of gestation. Conclusion: Assistance provided to pregnant women is a strategy that really determines the success of the maternal and neonatal health empowerment program in making birth decisions using the VBAC technique
Recording: https://youtu.be/953OjyMpdtc
Speakers: Tanya Capper and Bridget Ferguson
Facilitator(s): Linda Deys
Abstract:
Safe and high-quality maternity care is crucial for ensuring the best possible health outcomes for both mothers and newborns (Renfrew et al., 2014). Unfortunately, recent incidents of preventable harm taking place within maternity services have underscored the importance of whistleblowing (Kirkup, 2022; Ockenden, 2022). Whistleblowing involves reporting incidents of wrongdoing with the goal of putting an end to poor practices and reducing risk. However, the act of whistleblowing may be met with significant barriers and adversity for the individual blowing the whistle. This presentation aims to discuss the findings of a scoping literature review that explores the experiences of health professionals, including midwives, who find themselves in the position of whistleblowing. The presentation will explain the key issues, barriers, and challenges that current literature has reported regarding whistleblowing in maternity services. These include the structural power that enforces silence, inadequate responses to whistleblowing, and the mechanisms by which whistleblowing is suppressed. It will also delve into the process of weighing up the personal risk to the whistleblower versus the moral obligation to protect mothers and infants.
Recording: https://youtu.be/DL-1qHliG9Y
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
Speakers: Rowsan Ara, Joy Kemp and Nabila Purno
Facilitator: Linda Wylie
Abstract:
Bangladesh is one of the most climate-change affected countries. Regular natural disasters, extreme heat, air-pollution and outbreaks of vector-borne diseases put thousands of pregnant women at risk, particularly in hard-to-reach locations with limited access to healthcare services. Midwives play a crucial role in addressing these challenges; they are often the first point-of-contact for women in the healthcare settings and can orient women about birth preparedness, disaster preparedness and in general protecting their health from known environmental and climate risks. The Government of Bangladesh has a workforce of 7,230 midwives. In 2023, a training manual on the Climate-Change Impacts on Sexual and Reproductive Health in Bangladesh was developed by CCHPU and UNFPA then reviewed with national experts. Existing curriculum review found commendable inclusion of gender equality, reproductive health and rights, and disaster management but weak content on the intersection between climate change and health. A three-day Training of Trainers (ToT) program was thus developed, targeting 20 Nursing and Midwifery faculty, serving as a catalyst to disseminate essential knowledge and equip educators with the tools to integrate climate change perspectives into their teaching methodologies. A series of cascade training ensued, with a day-long training for final-year Midwifery students and a specialized session for 50 practicing midwives across various health facilities. These efforts underscore the government’s commitment to ensuring a health-workforce well-versed in addressing climate-change impacts, particularly concerning sexual and reproductive health. This content must now be integrated into nursing and midwifery curricula across all education levels.
