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: Alison Eddy and Carol Bartle
Facilitator(s): Catherine Salam (Izza Alifina)
Abstract:
Te Kāreti O Nga Kaiwhakawhanau Ki Aotearoa | The NZ College of Midwives and their college members are promoting midwifery action on climate change and working towards supporting national and global initiatives which reduce the negative impacts of climate change. Wherever they work midwives can consider the environment and identify ways to minimise their impact both personally and professionally. Small actions can grow into a significant movement and midwives can advocate for social change in relation to sustainability and healthy environments. The ‘fingerprint of climate change’ has been described as beginning before a baby is born due to pregnant women already enduring environmental crises that their children will be exposed to after birth.[1] This presentation tracks how an increased awareness of the impact of climate change sparked the College into action aimed at supporting some mitigation of climate change via a lens on midwifery practice related to pregnancy, birth, and infant feeding. The College recognises the potential for midwifery globally to develop a model of excellence for climate action and sustainability and we will present what we have achieved so far, and the steps we are taking towards collective action.
[1] Pacheco, S. (2020). Catastrophic effects of climate change on children’s health start before birth. The Journal of Clinical Investigation, 130(2),562-564.
Recording: https://youtu.be/LRidySKzuBU
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
Speakers: Fabella Elisa Cahyaningtyas and Zalfa Dinah
Facilitator: Caroline Maringa
Abstract:
Background: The increase in cesarean sections has occurred throughout the world, especially in developing and developed countries, over the last few decades and has led to increased research, debate, and concern among health professionals, governments, policymakers, scientists, and clinicians. So, to overcome the increasing number of cesarean sections, the VBAC technique was developed, namely vaginal birth for pregnant women who have had a history of cesarean sections in previous pregnancies. 90% of women who have a cesarean section are possible candidates for VBAC during a subsequent pregnancy. 60%–80% of them are able to give birth successfully vaginally. Mentoring is defined as the process of providing convenience to clients in identifying needs and solving problems, as well as encouraging the growth of initiative in the decision-making process, in this case, the decision to choose VBAC. So this study article aims to describe assistance for a successful VBAC. Case Report: Assistance for a 36-year-old pregnant woman with G4P2013 since 25/26 weeks of gestation at one of the PUSKESMAS in Surabaya. BSC 2x: history of a happy pregnancy in the first pregnancy and history of curettage abortion in the second pregnancy. The last child is 2 years old. Have the desire to give birth naturally. Mother had a successful VBAC without tearing on 7/7/2022 at 39/40 weeks of gestation. Conclusion: Assistance provided to pregnant women is a strategy that really determines the success of the maternal and neonatal health empowerment program in making birth decisions using the VBAC technique
Recording: https://youtu.be/953OjyMpdtc
Speaker: Arafin Happy Mim
Facilitators:Raissa Manika Purwaningtias & Constance Odonkor(shadow)
Abstract:
I am Mim, a Young Midwife Leader from Bangladesh. One year ago, I assumed the role of supervisor of midwives on Basanchar, a remote island near Hatiya Upazilla, Bangladesh, catering to 32,574 people and 7899 families, many of whom were Rohingya refugees relocated from Coxs Bazar. The island faces numerous health challenges, especially for women and children, with limited access to medical facilities, requiring Navy Frigate transportation twice weekly. Upon arrival, I encountered midwives lacking confidence and support in their practice. As the first midwife supervisor, doubts surrounded my leadership abilities, compounded by the democratic system’s challenges. Despite skepticism, I prioritized listening, reflection, and evidence-based advocacy to empower midwives and amplify their voices. Through collaborative efforts, we transformed the team, nurturing leadership skills and expanding their scope of practice. With a multidisciplinary approach, we now offer comprehensive sexual and reproductive health services and manage most complications locally, minimizing the need for external transfers. Looking ahead, our focus is on community awareness, affirming the pivotal role of midwives, and ensuring their practice aligns with standards. Continued education and research will further enhance our contributions to midwifery in Bangladesh, fostering a culture of quality care and acceptance in Basanchar.
Recording: https://youtu.be/_PO0Pisbxww
Speakers: Rowsan Ara, Joy Kemp and Nabila Purno
Facilitator: Linda Wylie
Abstract:
Bangladesh is one of the most climate-change affected countries. Regular natural disasters, extreme heat, air-pollution and outbreaks of vector-borne diseases put thousands of pregnant women at risk, particularly in hard-to-reach locations with limited access to healthcare services. Midwives play a crucial role in addressing these challenges; they are often the first point-of-contact for women in the healthcare settings and can orient women about birth preparedness, disaster preparedness and in general protecting their health from known environmental and climate risks. The Government of Bangladesh has a workforce of 7,230 midwives. In 2023, a training manual on the Climate-Change Impacts on Sexual and Reproductive Health in Bangladesh was developed by CCHPU and UNFPA then reviewed with national experts. Existing curriculum review found commendable inclusion of gender equality, reproductive health and rights, and disaster management but weak content on the intersection between climate change and health. A three-day Training of Trainers (ToT) program was thus developed, targeting 20 Nursing and Midwifery faculty, serving as a catalyst to disseminate essential knowledge and equip educators with the tools to integrate climate change perspectives into their teaching methodologies. A series of cascade training ensued, with a day-long training for final-year Midwifery students and a specialized session for 50 practicing midwives across various health facilities. These efforts underscore the government’s commitment to ensuring a health-workforce well-versed in addressing climate-change impacts, particularly concerning sexual and reproductive health. This content must now be integrated into nursing and midwifery curricula across all education levels.
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
