Virtual International Day of the Midwife

The DOC Learning Tool

The Participatory Action Research study involved three phases, Exploration (Phase One), Intervention (Phase Two) and Evaluation (Phase Three). Phase One involved a World Café event where an Expert Working Group (n=19) created the DOC Learning Tool based on the NMC Standards. One hundred percent face and content validity of the Tool was achieved. Phase Two involved mixed methods of data collection: Testing the DOC Learning Tool over four cycles .24 clinical midwives from one Health Board in Scotland took part. In total 224 DOC Learning Tools were completed and analysed. Quantitative data was examined through descriptive statistics, revealing that over the four test cycles rater agreement changed from a mean of 68.10, to 78.17. Descriptive statistics revealed a reduced range in the variation of scores and a steadily increased mean score.

Results showed gradual increase while Cycle Four becomes significantly different from Cycle One. One inferential test was carried out ( one-way ANOVA) which revealed significant difference between Cycle One and Cycle Four. Qualitative data was obtained through three focus groups (n=9) and qualitative comments from the completed DOC Learning Tools. Thematic analysis (Braun and Clarke (2006) revealed two overarching themes relating to the DOC Learning Tool, including Mechanisms and Practicalities and Person Centred Engagement and Enhancement through Learning. There was clear evidence the DOC Learning Tool was in alignment with the NMC professional standards. Phase Three- Although triangulation of findings enhanced the areas of convergence and divergent resulting in ongoing improvements to the DOC Learning Tool over the study.

Giulia Maga, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Cristina Arrigoni (2); Lia Brigante (3,4); Rosaria Cappadona (5); Rosario Caruso (6,7); Marina Alice Sylvia Daniele (8); Elsa Del Bo (9); Chiara Ogliari (9); Arianna Magon (6): (2) Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy; (3) Department of Women’s and Children’s Health, Faculty of Life Sciences and Medicine, King’s College London, London, UK; (4) Royal College of Midwives, London, UK; (5) Department of Medical Sciences, University of Ferrara, Ferrara, Italy; (6) Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy; (7) Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; (8) Department of Midwifery and Radiography, School of Health and Psychological Sciences, City, University of London, UK; (9) Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy Developmental Strategy and Validation of the Midwifery Interventions Classification (MIC): A Delphi Study Protocol and Results from the Developmental Phase Midwifery interventions require a specific definition and classification consistent with the current midwifery standard care practices, focused on promoting a salutogenic approach to maternity care. As a result, this protocol aims to describe the developmental strategy and the methodological direction for validating a Midwifery Interventions Classification (MIC) based on the Italian context with the potential for international transferability, implementation, and scaling up. The scope of the MIC will cover healthy women with low-risk pregnancies and their newborns, from antenatal to birth and postnatal care.
Methods
This protocol designs a multi-phase approach. Stage 1 (Developmental phase) was recently completed and included a literature review to develop a preliminary and evidence-based version of the MIC; Stage 2 (Consensus process) will validate the classification through a Delphi survey involving key stakeholders: healthcare professionals, healthcare researchers, and service users. Midwifery interventions resulting from Stage 2 will be taxonomized into domains and classes encompassing the final version of the MIC.
Results
The preliminary version of the MIC consists of an initial list of 165 midwifery interventions based on a salutogenic maternity care framework. This preliminary version was outlined after extracting, translating, merging, and retitling 520 midwifery interventions provided by the 16 studies included in the literature review performed on PubMed, CINAHL, and Scopus.
Conclusions
The MIC will support audit and quality improvement, education, and comparable data collections for research, sustaining public recognition of midwifery interventions to promote optimal maternal, newborn, and public health outcomes.

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. 

This podcast talks behind the presentation to learn more about Molly O'Brien. https://vidm.org/

Peer Support in Capacity Building For Midwifery Association at Bantul District Indonesian Midwives Association (IMA) at Bantul District managed 840 midwives with 40 midwives as the board who very active and enthusiastic members. This characteristic of human resources in this organization have played a vital role to gain the goals, save mother and her babies. However, Maternal Mortality Rate in this region was high and draw a fluctuated trend. It pointed to IMA Bantul branch to ensure a quality organization management that directly impact to midwifery care. Global partnership project has run with midwife who representative from PUM Netherlands senior expert.

The aim is to issue a number of recommendations that contribute to improving the organization of midwives.

Method: A two weeks mission by midwife, a Senior Expert Health Care Services PUM. This Partnership project done by workshop, site-visit, meeting and discussing.

Result and Recommendation: There were 4 main activities; organizational support, support at community setting, personal midwife support, meet with midwife students and lecturer. These activities consist of interviews with those involved, observations on location, conversations with students and teachers, but also with pregnant women and women who have given birth. In addition, a number of workshops has been given. Those activities have produced a valuable suggestion for IMA Bantul to develop online system in their work, create a class for family preparedness and rise the income by optimize their asset.
Conclusion: Peer support among midwives gave opportunity to adapt and initiate for the new idea. Furthermore, for those suggestions would contribute to increase capacity of midwives organization.

A Mosaic of Maternal Mental Health Factors: Findings from four maternal mental health link work prototypes in the North East of England; understanding maternal mental health, health inequalities and unmet needs

Ang Broadbridge and Rachel McDonald Community link workers support women and families with what matters to them, this prototype project across four sites in the North East of England takes a place-based approach to addressing health inequalities and improving access to care, receiving referrals from midwives and other health professionals, connecting across settings including community, maternity and children’s services and amplifying maternal voices. Our poster shares findings from our prototypes as well testimonials from midwives and women who have received support about the value of collaborative working across health and voluntary and charitable sectors.

Health Seeking Behaviour (HSB) of Pregnant Adolescent: A Scoping Review

Adolescent pregnant women are a vulnerable group. They frequently experience emotional and physical issues related to their pregnancy. Understanding adolescent mothers is crucial, particularly in understanding healthcare-seeking behavior (HSB) and factors influencing HSB among pregnant adolescents.
Aim: To summarise the existing literature to provide insight into healthcare-seeking behavior among adolescent pregnant women.
Methods: The review adapted the five stages of Arskey and O’Malley’s framework. Six databases were searched using the terms. Data searching identified 1952 records. Twenty-five studies met inclusion and exclusion criteria.

Findings: Three key themes emerged; (1) women's experience of adolescent pregnancy, (2) Factors influencing HSB and ANC among adolescent pregnant women, and (3) The utilization of health services and antenatal care among adolescent pregnant women.

Discussion: Adolescents experience various feelings during their pregnancy, and responses to their surroundings will contribute to their HSB. Utilizing health services also gives adolescents tremendous experiences affecting their subsequent follow-up visits.

Conclusion: This review identified a number of enabling factors influencing HSB and ANC among adolescent pregnant women, including age, education, location, marital status, socio-economic position, and family support. The barriers to HSB included: difficulty getting permission, distance from health facilities, a lack of funds, a lack of knowledge, a lack of decision-making authority, a lack of education, a lack of wealth, negative emotions, negative perceptions, stigma from others, fear, violence, abuse, and negative experiences with health care and adolescent pregnancy. https://vidm.org/

In her conference presentation Liz draws together the various threads of her work to propose a political philosophy of birth space and practice. She examines how the ‘science’ (of knowledge production) affects the ‘art’ (of midwifery practice) using the example of epidural analgesia, water immersion and constructions of ‘safety’ in obstetric discourse. From this, she introduces the conceptual framework of the ‘institutional paradox’ – the framing of particular practices as safe or risky, the effects of ‘institutional momentum’, and the precarious positioning of midwives as ‘guardians of normal’ within a system that views birth as, at best, risky, at worst, pathological. Liz then shows how the influence of this institutional paradox leads to a form of rhetorical informed consent that enables dehumanising birth practices, before using the lens of care ethics to turn to the work of humanising birth, with a focus on relationality and the concept of attentiveness.

This podcast talks behind the presentation to learn more about Liz Newnham. https://vidm.org/

Fifteen years ago Sarah started the Virtual International Day of the Midwife (VIDM) on her kitchen table. The first year she pretty much spent talking to herself. Who could have guessed all these years later that a global pandemic, which would cause such devastation, would also make virtual conferencing an everyday occurrence. And that the organising committee could leverage COVID-19 into an opportunity to grow the VIDM to an audience of thousands across the world. In this presentation she reflects on the lessons learned over the years facilitating the VIDM about leadership, collaboration and innovation which are critical elements we need to influence and shape midwifery and women/people-centred care as we transition out of the pandemic.

This podcast talks behind the presentation to learn more about Sarah.

https://vidm.org/

Giving birth in freedom: alternative positions in birth and expulsive period.

Since ancient times, women have chosen the position in which to give birth. The excessive medicalization, however, has led to the prevalence of the woman's immobility. Semi-quantitative observational study conducted with convention sampling on 115 women who gave birth between March and April 2017 recruited at the time of discharge. A questionnaire divided into four sections was administered with the following object: 1) socio-demographic situation, 2) management of labor, 3) management of the expulsive period and maternal outcomes, 4) maternal satisfaction.   The data were divided into two groups: Group A (free positions) vs Group B (horizontal position). In the qualitative part of the questionnaire, the experience of women in the delivery room regarding freedom of movement or any postural coercion was collected. The analysis of the data shows that women who experienced freedom of movement said they had improved the experience of labor/delivery and the perception of pain.

To Weigh or Not to Weigh in Pregnancy

All women attending this service have their BMI calculated at booking. Healthy eating and a recommended weight gain of 15kg to reduce the risk of CS, hypertension and birth weight over 4kg are discussed. In May 2021 43 babies had birth weights over 4kg. This prompted the introduction of routine weighing for all service users and weight gain recommendations based on the Institute of Medicines (IOM) guidelines. A retrospective study of weight gain and outcomes for 53 pre and 46 post routine weighing service users was undertaken in January 2022. There was an overall 2% reduction in CS births, 22% reduction in babies weighing over 4kg. 40% of women gained in excess of recommendations with a 22% CS rate and 22% babies over 4kg. This simple intervention of routine weighing and healthy eating should be used as a long term investment in the health and wellbeing of all service users.

Mujeres y parteras: Fortalecimiento en red

RELACAHUPAN

(Red latinoamericana y del Caribe  por la humanización del parto y nacimiento )

El objetivo de la red está centrado en apoyar y promover la consolidación de modelos respetuosos de atención a las mujeres y familias durante sus procesos de gestar, parir, nacer.

Siendo múltiples los contextos  y realidades en Latinoamérica y el Caribe, las parteras siguen siendo  personas claves en el cuidado de la vida, no solo por su pertinencia social , si no por su valiosísimo conocimiento y auténtica empatía.

Queremos compartir en este espacio, lo que es la RELACAHUPAN, algunas iniciativas que suman al reconocimiento de las parteras y dignificar su práctica en los distintos contextos , así como promover las alianzas en red como estrategia para seguir concretando en el cotidiano los derechos de las mujeres y de las mujeres parteras.

Women and midwives: Strengthening Through Network

RELACAHUPAN

(Latin American and Caribbean Network for the Humanization of Childbirth)

The objective of the network is focused on supporting and promoting the consolidation of respectful models of care for women and families during their pregnancy and childbirth  processes.

In the face of multiple contexts and realities in Latin America and the Caribbean, midwives continue to be key in the care for life, not only because of their social relevance, but also because of their invaluable knowledge and authentic empathy.

We want to share in this space, what RELACAHUPAN is, some initiatives that add to the recognition of midwives and to dignify their practice in different contexts, as well as to promote network alliances as a strategy to continue concretizing the rights of women and women midwives in daily life.