Speaker: Lia Brigante
Facilitator: Caroline Maringa
Midwifery continuity of care (MCoC) has been associated with improved maternal outcomes and with lower levels of preterm births and stillbirths. The majority of MCoC studies have focused on women without risk factors and little has been published on women with obstetric complexities. The aim of this study is to explore the views and experiences of women identified as a higher risk of preterm birth who have had continuity of care from midwives.
Design: Face-to-face, semi-structured interviews with 16 women identified as at increased risk of preterm birth and experienced continuity of midwifery care across pregnancy, birth and the postnatal period. Care had been provided by the pilot intervention group for the pilot study of midwifery practice in preterm birth including women’s experiences (POPPIE) trial.
Findings: Women valued continuity of midwifery care across the care pathway and described the reassurance provided by having 24 h a day, seven days a week access to known midwives. Consistency of care, advocacy and accessibility to the team were described as the main factors contributing to their feelings of safety and control.
Key conclusions: Recognising that known midwives were ‘there all the time’ made women feel listened to and actively involved in clinical decision making, which contributed to women feeling less stressed and anxious during their pregnancy, birth and early parenthood. When developing MCoC models for women with obstetric complexities: access, advocacy and time should be embedded to ensure women can build trusting relationships and reduce anxiety levels.
Recording: https://youtu.be/iK-Cr2puBZg
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
Speaker: Ginger García Portocarrero
Facilitator: Susana Ku
El Colegio Regional de Obstetras III Lima – Callao, ha venido desarrollando un voluntariado en ayuda a la Maternidad Segura brindando temas en: consejería, telemedicina y campañas de salud reproductiva para los lugares más precarios de la ciudad.
Para este 2023, estamos relanzando voluntariado con el nombre de Brigada PRO (Primera Respuesta Obstétrica), que incluye temas de: soporte básico de vida, atención prehospitalaria de emergencias ginecoobstétricas y Gestión del Riesgo de Desastres; para asegurar una buena atención en los lugares menos accesibles de nuestra región. También, pretendemos contagiar y compartir el voluntariado para formar la organización: Obstetras Sin Fronteras.
En esta renovación se les dotará de un traje táctico especial para el trabajo de campo que las pueda identificar y desempeñarse mejor en sus actividades.
English:
The Regional College of Midwives III Lima – Callao, has been developing a volunteer program in support of Safe Motherhood providing counseling, telemedicine and reproductive health campaigns for the most precarious places in the city.
For this 2023, we are relaunching volunteering under the name of “Brigada PRO (First Obstetric Response)”, which includes topics such as: basic life support, pre-hospital care of gynecological and obstetric emergencies and Disaster Risk Management, to ensure good care in the least accessible places in our region. Also, we intend to spread and share volunteering to form the organization: “Midwives Without Borders”.
For this project, midwives will be provided with a special tactical suit for field work that will help them to identify and perform better in their activities.
Recording: https://youtu.be/zfwrQxweOwA
Speaker: Florence Wilcock
Facilitator: Ally Anderson and Liticia Arthur
I am fortunate to work in the UK NHS within a midwifery-based system of maternity care where the role of the midwife is well recognised and respected. Despite this maternity care can sometimes break down and become a ‘them and us culture’ with conflict between different staff groups with midwives perhaps seen as advocates for women in contrast to obstetricians using a more paternalistic and medicalised model. I know in other regions in the world this can be even more marked with very obstetric based models and obstetric nurses in some countries or else with limited access to either profession in others. In this talk I will discuss my experiences of working alongside midwifery colleagues to try and enable women centred holistic care as well as making some suggestions of how you might build effective working relationships with obstetric colleagues.
(FRCOG aka TheObsPod)
Recording: https://youtu.be/jx2ANo8ZmnE
Speaker: Lieselotte Vandeputte and Elke Van Den Bergh
Facilitator: Eunice Atsali and Hannah Yawson
The annual report on midwifery-led care during childbirth focusses on midwifery-led care in Belgium. It is the second report to address the underreporting and need for transparency of the work that midwives do autonomously in Belgium.
Design and setting: The research was conducted through an online registrations form. Midwives could register each birth they attended or autonomously performed. 31 midwifery practices with 108 self-employed midwives primarily employed in Flanders and Brussels participated in this registration. Measurements and findings: In total 1,587 labours that started in first line and were also initially planned to give birth in first line under supervision of the midwife were registered. Of these 1,587 registrations, 1,311 deliveries were performed autonomously by the midwife: 695 deliveries took place at home, 278 deliveries were assisted in a hospital, 155 deliveries in a birthing house and 182 in a midwifery led unit inside of a hospital. One delivery took place on the way to the hospital. Finally, 276 women were referred intrapartum to the hospital for medical reasons after which delivery took place under the supervision of the gynecologist.
Key conclusions: MLC is safe and of high quality. Women have a higher chance of a physiological birth. Maternal and neonatal outcomes are excellent and in line with scientific literature. Implications for practice: There is a need for expanding the research into French speaking Belgium and to disseminate more the good results of midwifery led care as a safe and valid birth choice, given the increased demand for it.
Recording: https://youtu.be/99ko4df0kdc
