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: Linda Deys
Facilitator: Linda Sweet
Midwives traditionally guide, create safety and share goals with women through labour and birth. Childbirth is recognised as a woman’s right of passage, with a positive experience associated with a sense of control and how she is treated and made to feel. When the birthing landscape is an operating theatre, women lose their autonomy and the midwives’ role of being ‘with-woman’ is challenged. Separation of mothers from their infant is common.
Design: Using a feminist phenomenological framework, fifteen women who experienced non-medically indicated separation from their infant at caesarean section were interviewed.
Results: Preliminary data analysis using a Modified van Kaam approach shows feelings of powerlessness, loneliness, sadness and frustration which lasts well beyond the perinatal period. It impacts their personal relationships and plans for future births. The results reflect a patriarchal, staff-focused environment where women are disregarded and do not feel safe.
Conclusion: Separating mothers and babies at caesarean section negatively impacts birth experience. Midwives have the opportunity to recognise power imbalance and create a sanctum within the surgical environment. Recognising that birth is more than the mode of delivery, midwives are often the only ones in a position to be the woman’s advocate at a caesarean birth. Midwives have the opportunity to create an environment where the woman has power and agency over her body and baby. Separating a mother from her baby can negatively impact her birth experience and future personal relationships.
Recording: https://youtu.be/is7ho3NoP4w
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
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
