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
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
Speaker: Erin Hanlon
Facilitator: Cecilia Jevitt and Akusmayra Ambarwati(Shadow)
Abstract:
Since 1990, New Zealand midwives have been privileged to elect to work within tertiary or primary health settings, employed, self-employed (case-loading), or a hybrid variation of both. However, despite the availability of midwife-led care, the local home birth rate has not substantially increased nor have medical interventions decreased, despite having a continuity of care. Narrative Inquiry methodology and methods were used to investigate the changes in the birthing culture in New Zealand from 1990 to today. The elements of temporality (time), sociality (social context), and place were borrowed from Connelly and Clandinin (2006) to collect and analyze stories from midwives and consumer participants nationally. This presentation initially maps the history of midwives gaining autonomy in New Zealand, then explores the experiences of midwives who spoke about a transition in their clinical practice from working within a highly medicalised model across the spectrum to attend home births. These hospital-trained midwives’ shared their stories of how performing highly technological services in labour instilled fears around birth. Participants discussed that in order to become home birth midwives, they needed to unlearn and then relearn the skills required to attend women birthing at home. Using temporality and sociality contextualized their accounts, as participants shared their experiences of how they discovered what birth ‘could be’ with less interference, which separated them apart from the dominant medicalised culture surrounding birth. As they relayed their stories around their relearning, they expressed a collegiality with other practitioners, and supportive, trusted relationships with women.
Recording: https://youtu.be/cG21rLXEzmo
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
