Acupressure for induction and augmentation of labour

Loredana Zordan, Independent midwife, Italy

Acupressure is an ancient Chinese technique based on the principle of acupuncture which involves the use of finger pressure (without the needle) on specific points along the body. Chinese culture believes the points to the junction of the meridian pathway that carry energy called QI, Acupressure stimulates the bodies own energies to help fight illness and restore harmony. Acupressure has also been used to stimulate contractions, helping to induce labour. Induction of labour is common as Post maturity can pose risks for the pregnant women and the unborn child, increasing the risk of stillbirth. Acupressure helps to establish contraction and promote cervical dilation. The acupressure points commonly used for induction of labour, have a very strong effect on the energy of the uterus, causing uterine activity and promoting a downward expulsion of the foetus. We have chosen to focus on acupressure rather than acupuncture as acupressure is a less invasive procedure and has the advantage that the woman or her partner can administer it themselves. The case presentation here reports a case of successful use of acupressure for induction and augmentation of labour for post maturity in a home birth situation.

Reviewing evidence and revisiting the option of caesarean sections in breech mothers by offering physiological breech as a choice of birth

Kalavathi Mudili and Inderjeet Kaur, Fernandez Foundation

Introduction: At Fernandez Foundation, the Breech clinic was introduced weekly in June 2019 after multidisciplinary breech training by Shawn Walker. Method: Retrospective data collection of 68 low risk mothers with breech presentation between 32-38 weeks attended breech clinic from June 2019 to March 2020. Results: Spinning baby exercises explained at the initial visit. 27 babies (45%) turned cephalic when checked for presentation between 36-37 weeks. 8 notes were misplaced, 33 mothers (55%) offered ECV. 14 (42%) mothers accepted ECV and 7(50%)were successful. Out of 19 (68%) mothers 5(26%) accepted the choice of a Vaginal Breech Birth and 3 (60%) mothers had physiological Breech Birth. There were no maternal or fetal morbidities in Vaginal Breech Births. Conclusion: The breech team and midwifery consultations offered mothers who were eligible, the choice of physiological breech birth. This will also impact on the caesarean section rates for breech presentation.

Midwifery postpartum clinical guideline following a term stillbirth

Barbora Snuggs, University of North Georgia, Vanderbilt University, USA

Many pregnancies and births bring joy and excitement while some end with the death of the baby prior to labor and delivery, also known as an intrauterine fetal demise (IUFD) or a stillbirth. Midwives are closely involved in care for these women during labor and delivery, but evidence-based care guidelines related to midwifery care during the postpartum period following a term stillbirth are limited in the literature published in the United States. A midwifery guideline was developed based on 1) a needs assessment, 2) a literature synthesis, and 3) current guidelines to care for women following a term stillbirth in the initial 6-week postpartum period with input from obstetrician-liaison and the midwives working in a practice setting. Midwives can care for patients utilizing their clinical knowledge with skill, empathy, and compassion by following an established term stillbirth postpartum clinical guideline.

Signs of a healthy birth / Zeichenlehre der gesunden Geburt

Rafaela Joos

Signs of a healthy birth. Observation of the healthy birth process by midwives. Background: «Unique normality», that each person’s uniqueness is normal for them, has been recently postulated in the literature as a new paradigm in midwifery practice. Midwifery skills should include a holistic, woman-centered care during a healthy birth. Instead of a linear approach where, birth should be considered as a circular process. Method: Within the setting of action research, four semi-structured interviews with midwives with expertise in the field of birth centre or homebirth were conducted and an observation chart for the healthy birth was developed. The qualitative interview analysis was carried out with the Mayring method. Results: The multi-faceted knowledge of midwives is demonstrated. A comprehensive observation chart for the observation of a healthy birth could be provided. Conclusions: Each birth is unique and requires continuous individual observation by the supervising midwife.

Pregnant women during the COVID-19 pandemic in Indonesia: Knowledge, anxiety and motivation

Niken Bayu Argaheni, Universitas Sebelas Maret, Indonesia

Background: The COVID-19 pandemic threatens such as pregnant women who are predicted to be at higher risk and more susceptible to exposure. The purpose of this study was to find out the knowledge about COVID-19 among pregnant women and how their motivation to continue pregnancy.

Methods: Researchers collaborated with SEKOCI (Sekolah Komplementer Cinta Ibu) to provide bold counseling to its members consisting of 69 pregnant women from various cities once every 7 days for 1 month, then an online questionnaire was evaluated the knowledge, the feelings and motivation for pregnancy during the COVID-19 pandemic.

Results: This study shows that respondents who have good knowledge about COVID-19 (76%), experience moderate levels (69%), and have motivation to do pregnancy (93%).

Conclusion: Pregnant women in Indonesia have good knowledge about COVID-19, and still have the motivation to come to health workers.

Improving midwifery students motivation and learning outcome in contraceptive course

Erika Agung Mulyaningsih, Stikes Pemkab Jombang, Indonesia

UNESCO said 73% of schools were closed for 3 months or more due to the Covid-19 pandemic. Face-to-face learning at Diploma III Midwifery Program has been stopped for more than 9 months. Efforts to achieve competence in Midwifery Education are a problem that must be solved innovatively. The purpose of this study was to improve student motivation and learning outcomes through the Lesson Study method. The method of this research is Classroom Action Research which is conducted in two cycles, The research was conducted on third semester students on contraceptive study materials which consisted of 9 topics. Lesson study can increase student motivation and learning outcomes. Various innovations and creativity are needed for students and lecturers to continue learning and teaching in a pandemic situation which is supported by the management in improving the quality of learning.

Promoting a positive norm towards planned home birth practice among midwives: A randomised controlled trial

Auwalu Muhammed, Department of Nursing Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto; Lee Khuan; Shariff-Ghazali Sazlina;  Salmiah Md Said; and Mairo Hassan, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia

This study was to determine the effect of a PHB education in promoting a positive norm towards PHB among midwives. A parallel group randomised controlled trial was conducted among 226 midwives. A close-ended questionnaire was used for data collection. The intervention group received training, while the control group maintained a usual care. Data were re-collected at immediate-post, and three months follow-up. Statistical analysis showed a significant change in the mean subjective norm within the intervention group (p;lt;0.001), but not in the control group (p =0.140). The participants in the intervention demonstrated a more positive norm towards PHB practice compared to the control group at immediate post-intervention (p & lt;0.001, d =0.9), and three-month follow-up (p & lt;0.001, d=0.9). PHB education is effective in promoting a positive norm towards PHB practice among midwives. The finding may inform midwives and policy makers on the strategy to create a network of collaboration towards safe motherhood.

Midwives' knowledge of pre-eclampsia management: A scoping review

Midwives in poorly resourced settings are engaged in pre-eclampsia management and deliver lifesaving interventions depending on the prescribed scope of practice. Therefore, we aimed to produce a synthesized summary of what midwives from around the world know about pre-eclampsia management. Method: We utilized the Joanna Briggs Institute (JBI) format and the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis extension for scoping reviews (PRISMA-Scr) checklist. 

Results: Following application of the inclusion criteria, twenty journal articles from low- and middle-income countries and nine guidelines were reviewed. Three main themes identified related to management whilst the last theme described how contextual factors led to either increased or decreased knowledge of pre-eclampsia. Conclusion: Midwives in some low- and middle-income countries have knowledge deficits of several aspects of pre-eclampsia management. The review suggests pragmatic steps are urgently needed to strengthen the knowledge base of practicing midwives in resourced constrained settings.

Nikoleta Chatzipanagiotidou, Midwifery Department, University of Western Macedonia, Greece

Lupus is a chronic systemic autoimmune disease that occurs when the body's immune system attacks its own tissues and organs because it cannot tell the difference between viruses, bacteria, and other germs and the body’s healthy cells, tissues, or organs. Out of 1.5 million Americans with Lupus, 90% are women between the ages 15-44. Lupus affects them greatly when it comes to making the decision of getting pregnant. There are a lot of misconceptions that Lupus prevents people from getting pregnant and there is not enough information given to those who are interested and the results of that are showing very clearly on the studies that have been done. This poster aims to provide accessible, evidence-based knowledge on the subject of pregnancy with Lupus in order to inform people about the possibilities that women with Lupus have on the matter of becoming pregnant.

Marcela Mendoza es una obstetra peruana que actualmente reside en Australia.

Esta es su tercera conferencia como facilitadora/moderadora y nos cuenta cómo ha sido su experiencia en estos últimos años desempeñando este rol. Que significa Equidad de Nacimiento para Todos. Y también anima a personas interesadas a formar parte del equipo de facilitadores para las próximas conferencias del VIDM.

Marcela is a midwife from Perú, currently residing in Australia.

This is her third conference as a facilitator, and she tells us what her experience has been in the last years participating in this role. What does Birth Equity for All mean to her? And she also encourages people interested in becoming part of the facilitator group for the coming VIDM conferences.