Speaker: Susana Ku
Facilitator: Paola Wilkin
We are a growing transnational collective consisting of members from the Global South and North, including midwives, doulas, scholars, educators, and mothers calling for an expansion of midwifery research to include what we coin “Critical Midwifery Studies”. We envision a Critical Midwifery Studies that uses three principles: 1.engagement and collaboration with rapidly developing fields within critical theory, 2.midwifery-led, 3. self-critical (developing ways to implement critical theory into practice). Systemic injustice is a threat to sexual, reproductive, maternal, and newborn health, hence the application of the art and science of midwifery. The effects of this injustice are reflected in the high maternal and neonatal morbidity and mortality rates in formerly colonized countries of the Global South, in marginalized communities of the Global North, and in underprivileged classes around the world. We aim for an open discussion about midwifery research, education, practice, policy, and regulations, that are largely White and Western-centric, using positivistic and universalist principles of biomedical research. Although we recognize the global struggle for legitimacy that midwives face as they work to make their models of care more accessible, this coincides with pressure to engage with dominant and dominating paradigms, using language and approaches that are valued by regimes of power.
Our presentation will include a summary of our experience launching the first bilingual summer school for Critical Midwifery Studies held on July 2022, with delegates around the world. We will explain how our collective planned this activity including principles of equity and accessibility https://tinyurl.com/yc55dbw6.
Recording: https://youtu.be/TKrSfdmC9nM
Speaker: Joy Kemp and Sharmin Shobnom Joya
Facilitator: Aisha Salihu Abdullahi
A 5-year twinning partnership between the Bangladesh Midwifery Society (BMS) and the Royal College of Midwives UK was completed and evaluated in 2022; results will be shared in this presentation. Twinning was both organisational and individual. Midwives are new in Bangladesh; they are negotiating professional space. UK midwifery is more established but the workforce is not representative of the population with Bangladesh heritage (1%); maternal and perinatal outcomes are worse for South-Asian families. Therefore, twinning had potential benefit for both contexts.
Objective: To evaluate if twinning had mutual benefit, especially in strengthening midwifery leadership.
Methods: A mixed methods enquiry using document-review, surveys, focus-groups, key informant interviews and participant observation. Evaluation framework informed by OECD criteria and stakeholder questions. Thematic data analysis.
Results: BMS’ organisational capacity increased significantly during the partnership. Fifty-one young midwife leaders in Bangladesh were developed and six won international leadership fellowships. Seven quality- improvement projects in Bangladesh were successfully completed, advancing midwifery services. UK midwives valued and learned from their participation. The partnership enabled greater engagement with South Asian diaspora midwives in the UK and highlighted inequity of UK maternity outcomes. The COVID-19 pandemic brought both challenges and opportunities for innovation.
Conclusions/Summary: This partnership strengthened midwifery associations and midwifery leadership and impacted every area of the ICM’s Professional Framework in Bangladesh. Twinning facilitated reciprocal benefits in both countries and may be replicable in other contexts.
Recording: https://youtu.be/jCiv_7LqMnA
Title: Biomechanics for birth: New learning & insights for practice: The 3 R’s
Speaker: Molly O’Brien
Facilitator: Linda Wylie
Midwifery work is wide ranging. In essence we are public health practitioners, protecting, maintaining and enhancing the health and wellbeing of women and their families. As skilled practitioners we seek to understand and mitigate myriad factors that contribute to ill health while aiming to support and optimise birth physiology as per our code of proficiency.
Specifically, the presentation focuses on labour dystocia and the midwifery skill of recognising when birth goes awry using the art and science of watchful attendance. It looks at ways to support physiology to reduce difficulties during the birth process and seeks to resolve mechanical difficulties by optimising physiology including the use of biomechanical techniques.
This presentation highlights areas of midwifery training and education that hinder understanding of anatomy and physiology in relation to the birth process and the baby’s journey through the pelvis. It examines the impact the dominant biomedical model of care has on midwifery practice, the profession as a whole and the women who use the service.
Recording: youtube.com/watch?v=FVN63zUtXXI
Speaker: Margaret Jowitt
Facilitator: Adetoro Adegoke
In ancient times Hippocrates considered that at the appointed hour the fetus put its feet against the fundus of the uterus and pushed but for the last 500 years the baby has been relegated to being a passenger in the story of birth. In the 21st century it is time to consider how material and structural remodelling of the uterus and cervix in the last four weeks of pregnancy unleash the body’s ability to help the birthing baby find the best way through the pelvis. At crowning, the fetus activates his mother’s fetal ejection reflex to release oxytocin and complete his journey. The mother and fetus need to move instinctively to enable each to act on the other to effect a straightforward birth.
Being with women throughout labour, midwives are ideally placed to advance scientific knowledge of how birth works. They observe the evolving hormonal milieu as labour progresses, they see how the mother’s mind and body work in concert with her fetus to provide a smooth passage. They recognise the importance of the social, emotional and physical environment in facilitating or impeding birth. A better understanding of the mechanobiology of birth will avoid aggressive medical and surgical intervention which can disrupt the transition to confident motherhood.
The art of midwifery is to educate and inspire the mother to trust the power of her body and her baby to work together in birth, and also to recognise when more help is needed to achieve a safe birth.
Recording: https://youtu.be/K5xj_GBnhVY
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
Speakers: Monique Vermeulen and Michelle Gray
Facilitator: Caitlin Goodwin
Abstract:
PURPOSE: Case-based learning (CBL) is often used in nursing and midwifery education to explore authentic clinical scenarios to support student learning. Some curricula use new cases each semester/trimester, some continue cases across the year, and others use a ‘caseload’ of women across a midwifery degree, enabling students to follow the history of women in their caseload. This study aimed to explore students’ perceptions of varied models of CBL used to support student learning to prepare for clinical midwifery practice and continuity of care. METHODS: Midwifery students from three universities across Australia, were recruited to participate in online and face to face group interviews in this exploratory descriptive study. Audio recordings were transcribed and thematically analysed. RESULTS: Students across all programs valued CBL for developing their critical thinking and clinical decision-making. They felt they were good discussion starters to learn together and reflected clinical practice. Students appreciated when the CBL case was used across multiple areas of learning however found they were generally not reflective of continuity of care with new cases introduced each week. Recommendations included increasing accessibility with transcripts, video subtitles, audio cases and images to connect the text with a ‘woman’. Whilst some wanted more cases, having too many cases at a time was considered not reflective of clinical practice. More detail, akin to a medical record, was desired. CONCLUSION: Scaffolding learning across the duration of a degree is a critical pedagogical practice. CBL is beneficial, but it is important to seek student feedback to improve educational practices.
Recording https://youtu.be/_oU0l0aqMVs
Speaker:Jennifer Moffitt
Facilitator: Caitlin Goodwin
Abstract:
Bringing the practices of mindfulness to our patients and ourselves can significantly impact our patients’ relationship to pain and fear in labor, birth, and life. In this presentation, participants will have an opportunity to experience a mindfulness practice and learn ways to implement mindfulness in midwifery, including for childbirth and parenting. Participants will be exposed to how mindfulness meditation can decrease stress during pregnancy and beyond and hear about mindfulness skills for working through pain and fear in childbirth. Further, participants will learn how to encourage mindfulness life skills for parenting with wisdom, kindness, and connection from the moments of birth, as well as how mindfulness skills may be implemented as a way to disrupt intergenerational patterns of suffering. In particular, this presentation will offer concrete ways to bring mindfulness to the contractions of labor, and to the space in between the contractions of labor. The potential for separating “pain” from “suffering” using mindfulness practices will be explored, which can be applied to labor, and of course, to life. We will examine the research around mindfulness-based interventions, the relationship between perinatal stress and outcomes, and the potential that mindfulness strategies have for reducing health disparities.
Recording: https://youtu.be/9VIUNKd_WoY
