Cathy Ashwin, Editor, MIDIRS Midwifery Digest
Midwifery lives in an evolving and ever changing world, in which midwives strive to give the highest level of care to all women and their families. Sometimes it’s difficult to keep up the pace and enthusiasm when we are faced with the dilemmas in our local workplaces.
For those fortunate to attend, what better place to reinvigorate our minds and bodies than at the ICM Congress in Prague last month, and for others, how refreshing to be motivated by the ideas brought back from the delegates.
I was there as a representative of MIDIRS and felt so proud to be a midwife and surrounded by other like-minded people, also humbled by some of the achievements and stories told by others.
One of the most inspirational speakers was Her Excellency Toyin Saraki, Founder Director of the Wellbeing foundation Africa (WBFA) who changed her life course, following her own personal experiences, to supporting improvements in children and women’s health.
For the past 22 years Toyin has worked tirelessly, engaging in humanitarian and development work. She is an international advocate in helping to reduce maternal and child mortality in Nigeria and with the introduction of the WFBA Personal Health Record, Africa will now move closer to reaching the recognised Millennium Goal developments (4 and 5).
These achievements cannot be attained alone, but with great leadership common goals can be reached through collaborative working of such like-minded individuals.
A further example of great achievement was also announced at the Congress, when Laila Fadl – a midwife from Sudan – was awarded the Jhpiego/ICM Pillar of Midwifery Award for outstanding contribution to midwifery.
Laila was instrumental in lobbying the Ministry of Health for midwives to be recognised in Sudan, which resulted in formal paid positions, midwifery education (two universities in Khartoum now offer bachelor of midwifery programmes) and establishing the Sudan Midwives Association. This will make a tremendous improvement in the care of women and babies in Sudan, where mortality rates are among the highest in the world.
The changes we make are not always so immediately life changing, with smaller changes also contributing to the overall global improvements in maternal and child health. The high standard of presentations and posters in Prague demonstrated some of the innovations and developments that have been achieved.
For example, Athena Hammond of Australia presented video clips of her study exploring the design and aesthetics of hospital birthing rooms. This opened our eyes to what most midwives would consider a ‘usual’ birthing environment, but when shown through video it was clearly noted how unsuitable the room was for a woman to give birth in a calm and uncluttered space.
Small changes that can be made to the environment do not cost money, just a little time and thought. So even in a relatively medical environment a woman can be herself and retreat into her own ‘birthing world’ free from external interference.
The outcomes for being able to birth in a more conducive environment would be a positive contribution to the improvement in birth satisfaction, which in turn may enhance maternal perinatal health reducing the risks of postnatal depression.
Another inspirational speaker was not a midwife, but a father – Gavin Banks, also from Australia. So moved by the whole concept of birth and women’s choices, Gavin has spent the last decade producing a film entitled ‘The Face of Birth’, in which women discuss many aspects of place of birth, including aboriginal culture and women’s choice of home birth.
One woman discusses why she chose to have an elective caesarean section. There are also short interviews with prominent midwifery researchers, including Lesley Page, the president of the Royal College of Midwives.
This film is intended for both midwives and mothers to view and does not contain any distressing footage. Although Gavin is passionate about midwifery, he assured us that his vocation is in film-making and that he has no intention of becoming a midwife!
No sooner had the Congress ended than excitement was raised again with the advent of another great achievement. June 23rd in London saw the launch of the Lancet Series – four key papers on midwifery examining the contribution midwifery care can make to all women and infants across the globe.
The series will provide a framework to support high-quality care, with women and infants being the focus. Rather than a fragmented medicalised approach to care, the series underpins the ethos of holistic care incorporating the definitions of midwifery, namely skills, knowledge and attitude.
The researchers explored what women need from maternal and newborn services, and this encompassed developed countries as well as those less developed. Universally women wanted respect, trust, kindness and personalised care depending upon need. Clinical knowledge was seen as a requirement alongside interpersonal and cultural knowledge and skills.
It was acknowledged that although maternity care included multidisciplinary working from associated professionals, the high-quality care provided by midwives improves the health and well-being of the women and families they support.
The improvements in system changes and service provision illustrated in the Lancet Series will be of benefit to all. In low income countries maternal and infant mortality will be reduced, and in higher income countries maternal morbidity will decrease.
I would also hope to see improvements in maternity services here in the UK for the wellbeing of women, and also improvements in the morale of midwives. Furthermore, I hope that the changes presented in the Lancet Series will contribute towards increasing job satisfaction for midwives. In turn, reducing the number of midwives leaving due to becoming disillusioned with the profession through burnout or being unable to give truly woman-centred care.
Hopefully the outcomes of the series will help to turn the tide, re-energising and instilling the motivation and enthusiasm that rippled through the ICM Congress. Many of us have great ideas within us to change how we work, but need our colleagues to come with us and work together to make this happen. From little acorns, great oak trees grow.
Do contact me on Twitter below to share these ideas. Together midwives have a strong voice, let it be heard!