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: Linda Sweet and Vidanka Vasilevski
Facilitators: Paola Wilkin and Diana Adarmes
Waste disposal is a significant cost to healthcare organisations. This study sought to understand the impact of a midwife-led intervention to improve waste segregation on staff knowledge and attitudes, waste volume, and waste management-related costs.
Design: A multi-method study including pre and post intervention staff waste management knowledge and attitude surveys and waste audits of bins located on the postnatal ward.
Methods: The intervention included education sessions, posters and signage by waste bins, and monthly newsletters distributed throughout 2021 to raise staff awareness of correct waste segregation processes. Pre-and post-intervention surveys were distributed in early 2021 and early 2022 respectively. The waste audits occurred on three occasions in 2021. The waste audit included total waste in kilograms, waste in kilograms by segregation, and identification of correct and incorrect segregation. Waste audit and quantitative staff survey data were analysed using descriptive statistics and Chi square. Qualitative data from the staff surveys were analysed using content analysis.
Results: Knowledge and attitudes to waste management were similar across pre- and post-intervention staff surveys. Knowledge of accurate allocation of specific items to waste streams was variable with errors identified in both the pre-and post-surveys. Waste audit data showed reductions in clinical waste at each measurement, with a 71.2% decrease in clinical waste from baseline to the final audit. The accuracy of waste segregation also improved from the baseline to final audit, resulting in a 48% reduction in waste management costs.
Conclusion: The midwife-led initiative improved waste segregation and achieved waste management cost reduction.
Recording: https://youtu.be/54KV1prNN_w
Speaker: Jialu Qian
Facilitator: Heather Brigance
Purpose: The psychological outcomes for many parents who experience perinatal loss depend on nurses’ and midwives’ ability to provide effective bereavement support. However, most nurses and midwives lack the ability in this field. The aim of the study was to explore obstetric nurses and midwifery professionals’ experiences with the Perinatal Bereavement Care Training Programme (PBCTP) after implementation.
Method: This qualitative study was conducted at a tertiary level maternity hospital in China. The PBCTP was implemented from March to May 2022. A total of 127 nurses and 44 midwives were invited to participate in the training. Obstetric nurses and midwives studied a 5-module training programme comprised of 8 online theoretical courses. Semi-structured telephone interviews were conducted with 12 obstetric nurses and 4 midwives from May to July 2022 as a post-intervention evaluation. Thematic analysis was used in the data analysis.
Results: Six main themes within participants’ experiences of PBCTP intervention were identified: aims of the training; personal growth and practice changes after training; the most valuable training content; suggestions for training improvement; directions for practice improvement; influencing factors of practice optimisation.
Conclusion: Nursing and midwifery professionals described the PBCTP as satisfying their learning and skills enhancement needs and supporting positive changes in their care providing for bereaved families. The optimised training programme should be widely applied in the future. More efforts from the hospitals, managers, obstetric nurses and midwives are needed to contribute to forming a uniform care pathway and promoting a supportive perinatal bereavement care practice.
Recording: https://youtu.be/sx7DJdpik9I
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
Title: Changing the course of history – Midwives, Midwifery
Speaker: Jacqueline Dunkley-Bent
Facilitator(s): Cecilia Jevitt
This session describes the impact of midwives as a ripple through generations and the significant contribution midwives make throughout the life course. Listeners will be challenged to reflect on their contribution to childbirth experiences and outcomes within the context of the changing world. Years from now will we throw up our hands or role up our sleeves? The session will end with a call to action.
Recording: https://youtu.be/RNcRroY3U2k
Speaker: Ang Broadbridge and Rachel McDonald
Facilitator: Raissa Manika Purwaningtias
Abstract:
Abstract summary: Sharing learning from four prototypes in the North East of England where we have developed new maternal mental health supports through collaboration and co-production across sectors, with key indicators of building sustainability Background – Project demonstrates improved maternal mental health through integrating third sector support into the pathway to reduce health inequalities and increase sustainability supporting the best start in life agenda with benefits for women, partners, their babies and the whole family unit in the perinatal period. The MMHS social prescribing link worker model aims to provide evidence based maternal mental health support based in the third sector: • The perinatal period is a time when women have regular contact with services, when there is a crucial window of opportunity to support a best start. • Building and integrating flexible third sector provision with referrals from midwifery, health visiting, mental health and community teams to overcome workforce capacity and waiting list pressures and threshold barriers complementing statutory offers through specialist, personalised non-clinical support Discussion • Project addresses health inequalities, issues for ethically minoritised communities and social determinants of health including sustainability and accessibility in rural and remote communities • Evidences benefits for mum and infant as well as wider family unit • Indicators of sustainability – developing sustainable community support networks, reducing duplication, developing eco-friendly accessible digital resources and supports and increasing digital inclusion Conclusion – Innovative and flexible approaches developed through cross-sector collaboration leading to sustainable practice and initiatives
Recording: https://youtu.be/ZwyvGbl7eNw
Speaker: Belle Bruce
Facilitator: Louela Cordova-Acedara
Abstract:
Background: There is a major research gap relating to the impact of intravenous (IV) fluids administration during labour on maternal and neonatal outcomes. It is biologically plausible that a relationship between volume of IV fluids and primary postpartum haemorrhage (PPH) exists. Aim: To investigate the relationship between intrapartum IV fluids and PPH. Methods: A retrospective cohort study was conducted in a tertiary hospital from September 2021 to September 2022. Inclusion criteria were singleton pregnancy, planning a vaginal birth, and admitted for labour and birth care between 37-42 weeks gestation. The study factor was IV fluids during labour. The primary outcome was primary PPH. Birth and postnatal data were obtained from the electronic medical records and paper fluid order documentation. Secondary outcomes included caesarean section and neonatal weight loss following birth. Results: 1023 participants were included of which 339 had a PPH (33.1%). Our main finding was that there was no association between high-volume IV fluids (≥2.5L) and PPH after adjusting for demographic and clinical factors (ORadj1.02 CI: 0.72, 1.44). However, there was a positive association between high-volume IV fluids and caesarean section (ORadj 1.99; CI: 1.4, 2.8) and neonatal weight loss (ORadj 1.8; CI: 1.09, 2.0). Conclusions: These findings are important to further knowledge relating to the administration of IV fluids in labour and the potential impact of this common practice. It identifies future research priorities around documentation of IV fluids and their relationship with pregnancy and perinatal outcomes.
Recording: https://youtu.be/sjOijsnYkWM
The Role of Midwifery in Respectful Maternal Care and Mental Health through the Wellbeing Foundation Africa’s Mamacare360 Program
Speaker: Toyin Saraki
Co-Presenters: Dr. Pragya Vishwakarma, Ms. Eunice AlexGreat Akhigbe
Facilitator(s): Halima Abdul
Abstract:
The Mamacare360 program, implemented by the Wellbeing Foundation Africa (WBFA) Midwives, is aligned with Goal 3 of the United Nations Sustainable Development Goals, which aims to ensure good health and wellbeing for all. Central to its mission is the enhancement of maternal health through the promotion of Respectful Maternity Care (RMC) for all women throughout the continuum of pregnancy, childbirth, and the postnatal period. Recognising the pivotal role of the relationship between pregnant women and their primary healthcare providers in shaping health outcomes for both mother and newborn, WBFA highlights the significance of this connection in fostering postnatal health and wellbeing.
Respectful maternity care is upheld as a fundamental human right, deserving of every childbearing woman within every healthcare system globally (WRA, 2010). WBFA advocates for this principle, emphasising the inherent dignity and autonomy of women throughout the childbirth process. This ethos is echoed in the Lancet Midwifery Series (2014), which asserts that midwifery is indispensable in addressing the challenges associated with delivering high-quality maternal and newborn care universally. Moreover, it is recognized as an effective strategy for promoting the health and wellbeing of women of reproductive age, newborns, and their families, thereby exerting a significant and sustainable impact on population health outcomes. Through a grassroots and community-led approach, Mamacare360 not only delivers essential maternal and child health services but also fosters a culture of empowerment and resilience among women.
This presentation will explore the multifaceted impact of Mamacare360, with a particular emphasis on the transformative power of midwifery. By bringing skilled midwives directly to the doorsteps of communities, the program ensures access to quality prenatal, childbirth, and postnatal care, thereby reducing maternal and infant mortality rates. By engaging with local women as advocates and educators, Mamacare360 cultivates a sense of ownership over maternal health, fostering sustainable improvements in healthcare-seeking behaviours.
The Mamacare360 program also acknowledges the often-overlooked aspect of maternal mental health. Recognising the profound impact of psychological wellbeing on maternal and child outcomes, the program integrates mental health support into its holistic approach. Through counselling, peer support groups, and community outreach initiatives, Mamacare360 addresses the unique challenges faced by mothers, promoting mental resilience and overall wellbeing.
Recording: https://youtu.be/8l4fhB_1C88
Enhancing Obstetric Prehospital Care: Insights from Midwives in Lima, Peru
Speaker: Ginger Garcia
Facilitator(s): Susana Ku
Abstract:
This presentation delves into the experiences of a dedicated group of midwives in Lima, Peru, who possess specialized training to provide prehospital care during natural disasters. Peru’s diverse climate often leads to natural disasters that directly impact communities, underscoring the critical need for immediate attention in such situations. While the overarching approach is holistic, special emphasis is placed on the most vulnerable populations, including women, children, and the elderly. The goal is to deliver swift and timely care, focusing on prevention and support for women amidst crises. Furthermore, sustainability is prioritized, with an emphasis on resource efficiency and waste reduction, promoting natural childbirth, exclusive breastfeeding, and optimal nutrition. Recognizing the adverse effects of climate change on maternal and fetal health, proactive measures are taken to address eventualities swiftly and effectively.
Check the time in your location: https://bit.ly/VIDM24-closing-session
Recording: Not Available
