Speaker: Paola Wilkin, Jane Houston, Megan Arbour
Facilitator: Paloma Terra
Postpartum Haemorrhage (PPH) remains one of Peru’s leading causes of maternal morbidity and mortality, with nearly 20% of maternal deaths caused by PPH in 2019. Early recognition of PPH and prompt treatment remains challenging in low-resource obstetric settings, including among Mestizo midwives in Peru. Midwives and obstetricians may experience barriers to the timely diagnosis and management of PPH including access to quantitative blood loss measurement methods, and timely haemoglobin blood laboratory tests. In addition, formalized PPH diagnosis and management training may not be available.
PURPOSE/AIM: The purpose of this quality improvement initiative is to increase the accuracy of postpartum blood loss measurement by Mestizo Peruvian midwives through hybrid educational sessions.
Methods: 3 international midwives collaborated to develop this quality improvement project. Clinically practicing midwives, midwifery interns, and midwifery students were recruited from the 2 main public hospitals in Arequipa, Peru to participate in a web-based training module, and subsequent live skills demonstration regarding how to quantitatively assess postpartum blood loss. The primary author is a Mestizo Peruvian dentist and midwife, and all materials were developed in a linguistically and culturally safe manner.
After the web-based training module, participants were surveyed on their level of comfort and self-efficacy with quantitative blood loss measurement using google forms, distributed via WhatsApp.
This quality improvement initiative was deemed exempt by the Frontier Nursing University IRB.
Results: Preliminary results and the next steps will be available and shared during the presentation.
Recording: https://youtu.be/UTrVPckPWUY
Speaker: Brenda Araujo Salas
Facilitator: Paloma Terra
A partir de las ilustraciones elaboradas por Yaquemilsa Matiashi Vicente, una joven madre del pueblo Matsigenka, perteneciente a la amazonía peruana, describiremos las prácticas tradicionales en salud materna que aún se mantienen vigentes en las comunidades más alejadas de la vida moderna. Se describirán las concepciones y prácticas culturales durante la primera menstruación, los cuidados en el embarazo, la atención del parto por parte de la familia y parteras, y los cuidados en el posparto.
Conocer gráficamente las prácticas en salud materna a través de la mirada de una mujer del mismo pueblo, nos permite visualizar detalles significativos que se dan en la los cuidados de las mujeres gestantes y los recién nacidos. La importancia de este material es educativa y en favor de una mejora en la atención del parto para fundar la comprensión y el respeto a las costumbres y participación de las parteras y especialistas tradicionales de salud, ya que, actualmente, gran parte de las comunidades amazónicas tienen acceso a establecimientos de salud, pero estos ofrecen servicios sin pertinencia cultural. Por otro lado, el material también permite el reconocimiento de la importancia de los conocimientos de las mujeres Matsigenka en los niños, niñas y adolescentes.
English:
From the illustrations elaborated by Yaquemilsa Matiashi Vicente, a young mother of the Matsigenka people, belonging to the Peruvian Amazon, we will describe the traditional practices in maternal health that are still in force in the communities farthest away from modern life. We will describe the cultural conceptions and practices during the first menstruation, pregnancy care, childbirth care by the family and midwives, and postpartum care.
The graphic presentation of maternal health practices through the eyes of a woman from the same village allows us to visualize significant details in the care of pregnant women and newborns. The importance of this material is educational and in favor of an improvement in childbirth care, in order to establish understanding and respect for the customs and participation of midwives and traditional health specialists, since, at present, most Amazonian communities have access to health facilities, but these offer services without cultural relevance. On the other hand, the material also allows the recognition of the importance of Matsigenka women’s knowledge in children and adolescents.
Recording: https://youtu.be/voZyHiTevvw
Speaker: Tracy Donegan
Facilitator: Portia Shanduka
80 – 90% of women who stop breastfeeding in the first six weeks are not ready to do so. Initiatives to improve breastfeeding rates have traditionally focused mainly on social policies, support and health promotion activities. In recent years therapeutic interventions such as mindfulness and self-compassion practices are emerging as an effective tool to increase breastfeeding self-efficacy while reducing mental health complications. Traditional antenatal breastfeeding preparation overlooks the influence of a dysregulated emotional state on breastfeeding outcomes. Antenatal breastfeeding classes are a prime opportunity for midwives to provide parents with evidence-based tools to manage psychological distress during this intense transition.
Mindfulness practices support parents to manage emotional turmoil and overwhelm including those who may experience breastfeeding grief. A mindful breastfeeding class can prepare parents with more than position, latch and newborn nursing information. This hybrid approach facilitates the development of cognitive skills to cultivate mental flexibility and emotional resilience to meet common challenges of early breastfeeding with self-compassion and self-kindness. This is critically important for parents with a baby in NICU who are at increased risk of developing mental health complications due to high stress levels. Recent primary evidence suggests that a mindfulness based approach to breastfeeding and postpartum is associated with an increase in breastfeeding initiation, duration, self-efficacy, parenting confidence and improved relationship quality. Infant mental health is also impacted positively.
Recording – https://youtu.be/X_5TJjN7PR0
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: Imelda Fitzgerald
Facilitator: Linda Wylie and Dwi Tampubolon(Shadow)
Abstract:
Childbirth is a unique experience for women. In Ireland, Major Obstetric Haemorrhage (MOH) is the most frequently reported severe maternal morbidity (SMM) with an incidence of 3.27 per 1,000 maternities. Much is known now about the management of PPH and there is some research on women and their partner’s experience, less is known about how the woman feels emotionally following a PPH, or what informational needs and emotional support is required. The aim of this study was to understand how women felt after experiencing a severe PPH, to listen to their first-hand experience and learn what improvements could be made for future care for women who experience a PPH. A descriptive, quantitative approach was conducted using semi structured interviews with women who had a severe PPH of 2.5 litres or above within four and fourteen months postpartum. five women took part in this study. The women identified a lack of information provided to them about the reason for the significant bleed. The women voiced they could overhear information about the event discussed between health care professionals but not with the woman. The care the women received in the HDU was significantly different to the care they received on the postnatal wards, and the women were not informed they were clinically well for transfer to the postnatal ward. It was reported the postnatal wards were busy and short staffed and the women looked for more emotional support from staff, which was not available, this had an effect on the postnatal wards.
Recording: https://youtu.be/6hvN0HJaZXw
Speakers: Yasmin Vaughan, Kathleen Pfohl and Mariama Massaquoi
Facilitator: Hayat Gomaa
Abstract:
Skilled birth attendants, particularly midwives, play a crucial role in reducing preventable maternal and newborn deaths. In January 2024, Helping Children Worldwide collaborated with six other organizations to host a 5-day training conference on emergency procedures in maternal and newborn health in Sierra Leone. Our presentation will argue that organizations should prioritize investments in training and supporting midwives in LMICs, highlighting the positive and sustainable impact on both health outcomes and broader development goals. Further, presenters will talk in a panel discussion about best practices for these trainings, highlighting practical steps to planning a training conference, lessons learned, and the value that collaboration brings to this work.
Recording: https://youtu.be/4hH_S_kiCis
