Support For Midwives Research Articles

Literature review: Peran bidan terhadap keberhasilan pemberian ASI Eksklusif

Background: exclusive breastfeeding in Aceh in 2021 (66.66%) has increased compared to 2020 (65.43%), but there has not been a significant increase. Efforts are needed to increase exclusive breastfeeding. Exclusive breastfeeding is one way of good growth and development. In addition, midwives play an important role in the success of exclusive breastfeeding. Midwives are responsible for exclusive breastfeeding education and care for breastfeeding mothers during pregnancy, starting from the first breastfeeding to breastfeeding mothers. Midwife support can also give mothers the confidence to continue giving exclusive breastfeeding to their babies.Objectives: to review several journals about the role of midwives in the success of exclusive breastfeeding.Methods: this research is a descriptive analysis. This research in literature review held ini may-june 2021. The keywords used are the role of the midwife and exclusive breastfeeding. Literature sources were obtained from the Google Scholar, Science Direct, and Pubmed publication databases with the last five years limitation A total of 224 articles were obtained with these keywords, then were selected in stages according to predetermined criteria. Retrieved 10 articles published in 2015-2020. The articles obtained were compiled, analyzed, and concluded by looking for similarities, dissimilarities, giving views, comparing and summarizing.Results: literature studies show that there is a relationship between the role of the midwife and the success of exclusive breastfeeding. Providing education, information and assessment about exclusive breastfeeding is the responsibility of midwives to mothers starting from the period of pregnancy, the beginning of breastfeeding until the baby is 6 months old.Conclusion: the midwife has a role in the success of exclusive breastfeeding

Influence of the birthing room design on midwives' job satisfaction – A cross-sectional online survey embedded in the ‘Be-Up’ study

BackgroundJob satisfaction is an important factor influencing work performance, personal well-being, commitment and retention. The working environment influences job satisfaction. The design of the birthing room could influence the practice of midwives and their satisfaction. This study investigates whether the alternative design of the birthing room implemented in the randomized controlled trial ‘Be-Up’ (Birth environment-Upright position) has an impact on job satisfaction of midwives. MethodA cross-sectional survey using an online questionnaire with 50 items addressing job satisfaction and birth room design was performed. The sample (n = 312) consists of midwives whose obstetric units participated in the Be-Up study and, as comparison group, midwives working in non-study obstetric units. These two independent groups were compared using t-tests; correlations and impacts were examined. ResultsThe results of the T-tests revealed statistically significant higher global job satisfaction and higher satisfaction with team support of midwives in the Be-Up room. However, midwives working in customary birthing rooms were more satisfied with the design of the room. The most important predictors of job satisfaction were team factors and understaffing in both groups. ConclusionReasons for diminished satisfaction with the working environment in the Be-Up study may be assumed in uncertainties about emergency management in a new and unfamiliar environment. Furthermore the impact of a single redesigned room within a customary obstetric unit on job satisfaction seems small, as the room is embedded in the ward and hospital environment. More comprehensive concepts on the potential of the work environment influencing midwives’ job satisfaction are needed.

Female Genital Mutilation: A Religio-cultural Sensitive Issue Determining Maternal Healthcare Choices among Somali Women in Dadaab Refugee Camp, Kenya

This paper focuses on Kenya’s development challenges in maternal health care, especially the impact of traditional birth attendants (TBAs) and female genital mutilation (FGM) among the refugees. The study identifies four objectives: to discuss the persistence of FGM among Somali women in Ifo Refugee Camp; to establish the hospital process of providing maternal health care to mothers who have gone through FGM; to find out the level of preparedness of the midwives to handle mothers with religio-cultural concerns such as prayer and non-involvement of male nurses; and how the practice of FGM contributes to the preference of TBA by mothers. This study assumes that midwives’ training may not have effectively addressed FGM, a social-cultural sensitive issue affecting childbirth and care. The specific support of midwives in refugee camps contexts also remains limited. A qualitative research approach was used in the study, involving Snowballing sampling method, in-depth interviews, and focus group discussions (FGDs). These methods brought out pertinent issues that make TBAs the preferential option for some mothers despite the presence of level 4 category hospitals in the refugee camps. In case of birth complications, the mother’s choice for TBA delays the family’s decision to take her to the hospital and for healthcare workers to save mother and child. The shortage of midwives and the presence of male midwives in hospitals make some Somali mothers seek assistance from TBAs. There is a need to contextualize midwifery training by enhancing the curriculum with evidence-based/mother-centered skills.

"We are in this together" - Polish midwives' reflections on perinatal care for Ukrainian women after the outbreak of war.

February 24, 2022, the beginning of Russia's invasion of Ukraine, was also the beginning of an exceptional situation and a challenge for the Polish health care system, the health care workers and Polish citizens. This study aims to conduct a qualitative analysis of midwives' experiences of maternity care for Ukrainian women after the outbreak of war. Eight midwives with experience working with both Ukrainian patients and Ukrainian war refugees (who came to Poland after February 24, 2022) participated in a semi-structured interview. The interview data were transcribed and thematically analysed to identify the observations, challenges and medical personnel needs. The most frequently observed reactions in Ukrainian patients included crying, increased anxiety and irritability, fear, withdrawal, and constant information seeking about the current situation. Breastfeeding problems understood as a consequence of chronic stress were also observed and assisted by the midwives. All respondents pointed out the language barrier and their involvement, showing empathy and attentiveness to the patients' situation. No hospital introduced additional support for midwives. A high level of emotional burden on midwives was observed. The midwives were eager to help Ukrainian patients - they emphasized the more frequent need to make themselves available for them. However, the emotional involvement of the midwives is accompanied by the risk of traumatization and burnout, which are associated with exposure to the difficult experiences of patients. Implementation of training in trauma-informed care and supervision could support midwives in their work and prevent the consequences of long-term stress. Systemic solutions concerning translators' presence and hospital documents' translation are also essential.

Silent Tears of Midwives: ‘I Want Every Mother Who Gives Birth to Have Her Baby Alive’—A Narrative Inquiry of Midwives Experiences of Very Early Neonatal Death from Tanzania

Midwives working in settings with limited clinical resources experience high rates of very early neonatal deaths. Midwives manage the impact of this grief and trauma almost daily, which may affect patient care and their own well-being. To explore how midwives are impacted by and cope with high rates of very early neonatal deaths. To document midwives' insights and local solutions that may reduce very early neonatal deaths in limited resource settings. To document the stories of midwives in order to create awareness and garner support for midwives and their critical work in low resource settings. Narrative inquiry utilizing semi structured interviews. Twenty-one midwives with at least six months experience who had experienced or witnessed very early neonatal death were interviewed. Data were audio recorded and transcribed, and reflexive thematic analysis of transcripts was conducted. Three themes were identified: (1) deep sadness resulting from very early neonatal deaths leading to internal struggles; (2) use of spirituality, including prayer and occasional beliefs that unexplainable deaths were 'God's plan'; and (3) development of resilience by seeking solutions, educating themselves, taking accountability and guiding mothers. Participating midwives noted that inadequate staff and high caseloads with limited basic supplies hindered their clinical practice. Participants articulated that they concentrated on active solutions to save babies during labour, such as vigilant foetal rate heart monitoring and partogram. Further, reduction and prevention of very early neonatal death is a complex problem requiring multidisciplinary teams and woman-centred care approaches to address issues contributing to the health of mothers and their new-borns. Midwives' narratives highlighted ways of coping with grief and deep sadness, through prayer, and further education of both mothers and fellow colleagues to achieve better antenatal and intrapartum care and outcomes. This study gave midwives an opportunity for their voices to be heard and to generate solutions or insights that can be shared with colleagues in similar low-resource settings.

Midwives' experience of delivering women with a life-threatening foetal diagnosis

Introduction: Taking care of a woman in the delivery room who is giving birth to a baby affected by a life-limiting foetal condition is a difficult experience for a midwife. Material and methods: In a qualitative study, semi-structured interviews were conducted with 10 midwives who are actively working in delivery rooms at four hospitals in various regions of Poland. The interviews were recorded, and then transcribed and analysed using the content analysis method with the MAXQDA tool. Results: From the experiences of midwives who deliver babies for women after an unfavourable prenatal diagnosis for the baby, two main themes and four sub-themes were identified. Within the first theme, “Impact in the scope of personal experience”, identified sub-themes included “Difficult but positive experiences” and “Confronting one's own emotions”. Within the second theme, “Impact in the scope of interaction with others”, identified sub-themes included “Empathising with the woman” and “Community with other midwives”. Conclusions: Taking care of a woman giving birth to a baby affected by a life-limiting fetal condition is for midwives an experience that is difficult, but ultimately positive and enriching for their personal and professional identity. Midwives need to be prepared through education to effectively deal with the problems which appear in their everyday practice. Psychological support for midwives is insufficient; an opportunity to participate in training courses would enable them to develop their skills related to handling difficult situations, coping with stress, and above all the ability to talk to mothers and fathers of the babies in those situations that are so difficult for the parents.

Factors that Determine the Self-Efficacy of The Maternal Care in Postpartum Women: Data for Future Memory

The birth of a child demands the provision of care. Mothers have different levels of safety or confidence when it comes to caring, which reveals the perception of self-efficacy. Our aim is to register, for future memory, the factors associated with self-efficacy in maternal care. Quantitative and cross-sectional study. It explores sociodemographic factors, factors related to the pregnancy and labor history, the newborn's characteristics, and related care environment with self-efficacy in maternal care. The study population included postpartum women from two Turkish maternity hospitals, in convenient sampling, with a response rate of 93,4%. Prudent ethical principles. The criterion variable was observed through the Perceived Maternal Parenting Self-Efficacy (PMP S-E). The statistical analysis was carried out on the SPSS software. The participants had an average age of 27.81(DP=5.13), the majority were married (95.9%) and for 40.1% this was their first child. The majority of labors were vaginal (52.4%). When it comes to the criterion variable, about 70% had a high perception regarding self-efficacy in maternal care. The univariate analysis revealed eight variables, included in the logistic regression: maternal age (p=.050), number of children (p<.001), number of prenatal appointments (p=.006), time that elapsed between the birth and the first episode of breastfeeding (p=.047), maternal safety while breastfeeding (p<.001), type of food given to the newborn p=.011), midwife support for exclusive maternal breastfeeding (p<.001) and maternal breastfeeding self-efficacy (p<.001). In the binary logistic regression, the best predictors of self-efficacy in maternal care were: midwife support for exclusive maternal breastfeeding (OR=1.092; B=0,088) and the self-efficacy in the maternal breastfeeding (OR=13.187; B=2.579). When it comes to maternal breastfeeding, both from the perspective of self-efficacy and the support offered by professionals, are the most relevant factors in the perception of maternal skills recognized by mothers. This study fills an information gap about the phenomenon, looking at it in retrospect.

Mothers' experiences of using Facebook groups for local breastfeeding support: Results of an online survey exploring midwife moderation.

It is established that access to ongoing informational, emotional and social support from trained health professionals including midwives assists mothers in meeting their breastfeeding goals. Social media is increasingly being used to offer this support. Research has demonstrated that support via platforms such as Facebook can improve maternal knowledge and self-efficacy and ultimately breastfeeding duration. One specific form of support that is under researched is the use of Breastfeeding Support Facebook (BSF) groups that are aimed at supporting women in specific local areas, often with links to face to face support. Initial research highlights that mothers' value these groups but the role that midwives play in offering support to local mothers through these groups has not been examined. The aim of this study was therefore to examine mothers' perceptions of midwifery support for breastfeeding delivered through these groups, specifically when midwives played an active role in being a group 'moderator' or leader. An online survey was completed by 2028 mothers who were part of local BSF groups comparing the experiences of those participating in groups moderated by midwives versus other moderators such as peer supporters. Moderation was an important factor in mothers' experiences, with trained support associated with greater engagement and more frequent visits, impacting on perceptions of group ethos, reliability and inclusivity. Midwife moderation was uncommon (5% of groups) but valued: midwife moderators offered a high level of support to mothers in their groups, with 87.5% having received midwife support often or sometimes and 97.8% rating this useful or very useful. Access to a midwife moderated group was also associated with viewing local face to face midwifery support for breastfeeding more positively. This is a significant finding, highlighting that online support complements face-to-face support in local settings (67% of groups were linked to a physical group), and improves continuity of care (14% of mothers who had midwife moderators received care from them). As such midwife moderated or supported groups have the potential to add value to local face to face services and improve breastfeeding experiences in communities. The findings have important implications to support the development of integrated online interventions to improve public health.

Supporting midwives in tough times

Cavell Nurses' Trust aims to assist healthcare workers experiencing hardship, providing emotional and financial support to nurses, midwives, maternity support workers and healthcare assistants

Maternal respectful care and Post-Traumatic Stress Disorder among postpartum mothers in Israel

Abstract Background Maternal Respectful Care (MRC) approach was recommended by the WHO for improving maternal birth experience and mental health. We examined the association between MRC and Post-Traumatic Stress Disorder (PTSD) among postpartum women. Methods A cross-sectional study took place between November 2020 and October 2021. 817 postpartum women (Jewish- 444 Arab-373) were interviewed via Zoom due to Covid-19 limitations. MRC was measured by 26 statements from disrespectful/ abusive care during childbirth in facilities (DACF); 4 statements from the Mother on Respect questionnaire (MOR-feeling mistreatment based on ethno-national background, level of command of the Hebrew language and disagreement with the staff); and 4 statements regarding abuse of the NorVold Abuse Questionnaire (NorAQ). PTSD was measured by Solomon et al.'s tool, and dichotomized into 12 score cutoff. (Yes /No PTSD). Results PTSD prevalence was 14.3%, significantly higher among Palestinian-Arab compared to Jewish women (22.0%,7.9%, respectively), and it was higher in women who had lower MRC scores: did not receive postpartum education (19.9%,11.9 % respectively) received; received midwife support 11.7%,18.4% didn't receive; reported racism 26.1%,11.4% not; Felt humiliated at healthcare services vs. not (16.8% , 10.6%, respectively); women who reported mistreatment based on national/cultural background, compared to others (MOR) (36.6%,13.1%, respectively). In the multivariate analysis after adjusting to different independent variables, Palestinian-Arab women were 6.04 times at risk for PTSD (OR = 6.04,95% CI = 3.38-10.78),Women who reported racism are 2.14 times more likely to PTSD (OR = 2.14, 95% CI = 1.30-3.54). Women who reported feeling humiliated visiting the health care system are 2.08 times more likely to PTSD (OR = 2.08,95% CI = 1.23-3.52). Conclusions MRC is an important factor for maternal PTSD among postpartum women and it should be considered specifically among minority women. Key messages

Determinant Factors Related to the Successful Smooth Delivery Process in the West Aceh District

The proportion of deliveries carried out at home and assisted by traditional birth attendants, especially in rural areas, is still high. Most cases of maternal deaths occur in hospitals and are referral cases. These conditions indicate that maternal deaths are due to being late in recognizing danger signs, and being late in taking care decisions is still high. The research focuses on identifying factors related to the smooth delivery process in West Aceh District. This research is an analytic survey using a cross-sectional approach. The research was conducted in West Aceh District. The population in this study were all mothers giving birth in West Aceh Regency in August-September 2021, as many as 94 people. The results showed that the husband's support had a significant relationship with the smooth delivery process in Aceh Barat District (p-value 0.089). Midwife support and maternal readiness are significantly related to the smooth delivery process in Aceh Barat District (P-value 0.001).

REBOUND MODEL TO TOWARD REGIONAL ECONOMIC RESURRECTION POST COVID-19 PANDEMIC IN BANYUWANGI REGENCY

Banyuwangi Regency which is located in the eastern sunrise of Java seeks synergistically to restore the economy after the Covid-19 pandemic, namely by echoing the Banyuwangi Rebound program which contains three main program for the era of revival, First, the pandemic handling ecosystem consists of various steps to deal with Covid-19 and improve the level of health of citizens in general, in addition to handling pandemics such as us towards one hundred percent of childhood vaccination, various preventive, promotive, curative, and rehabilitative measures we integrate. Including towards zero stunting, village midwife support, people's nutritional supplements, spurring sports activities, and revitalization of school health units, the next ecosystem is economic recovery. Starting from MSME development programs, agriculture, infrastructure, rural development, to tourism. They are designed to create jobs and restore the economic movement of citizens. The third ecosystem is harmony strengthens social solidarity, develops human resources in terms of education, maintains environmental sustainability, to strengthen harmony between religious people. Banyuwangi Rebound is a comprehensive movement reaching all sectors and stakeholders to bring Banyuwangi able to Rebound amoung various challenges. Economic growth is starting to return positively. The wheels of the economy began to move, one of the indicators is financing from banks to MSME that are soaring. Banyuwangi's banking credit growth is far above the national average. In addition, the culture of innovation developed by the government continues to develop, in the midst of this pandemic, the poverty rate rose even though Banyuwangi experienced the lowest increase in East Java 0.1%.

W3 - To-Get-There, Together: Creative Approaches to Mentoring Conversations

The workshop is designed to enable participants to experience some of the Appreciative Inquiry (AI) tools used within the NSW Health Mentoring in Midwifery (MiM) Program. The MiM Program aims to develop a reciprocal learning relationship that expands opportunities for connection, learning, growth and support for midwifery students and midwives working in NSW Health. The workshop will commence with an overview of the NSW Health MiM program as informed by relationship-centred practice and utilising an Appreciative Inquiry approach. Facilitators will work with participants in small groups to explore Appreciative Inquiry tools used within the MiM Program. In closing the workshop, participants will have an opportunity to reflect on the use of these tools and the variety of ways in which they can be integrated within practice. The workshop showcases the NSW Mentoring in Midwifery (MiM) Program and demonstrates how traditional hierarchical relationships can be opened up through the conversations that flow from the use of Appreciative Inquiry tools. Participants will gain insight into how these tools can facilitate conversations to quickly build relationships, uncover new learning, and support people to move forward, together. The Appreciative Inquiry tools practised at this workshop were included when developing a structured Mentoring in Midwifery Program in NSW to promote conversations about midwifery practice between the mentor and mentee. These tools are readily transferable and can be used in day-to-day practice to enhance conversations, engagement, reflection and learning in the moment with other staff, women, and their families.

O73 - Us, together- Co-creating a Mentoring in Midwifery Program in NSW

This presentation outlines the approach taken by NSW Health, Nursing and Midwifery Office to lead the co-creation and design of a new mentoring program for midwives. The NSW Health Mentoring in Midwifery Program (MiM) aims to develop a reciprocal learning relationship that expands opportunities for connection, learning, growth and support for midwifery students and midwives working in NSW Health. This presentation will outline how a co-creative process was used to collaborate with a range of midwifery leaders, midwives, and academics to envisage the MiM Program. The International Confederation of Midwives (ICM) Mentoring Guidelines and Principles of Appreciative Inquiry informed our approach. This presentation will describe the Senses Framework as the underpinning ingredient to promote learning in the workplace, and how this was enhanced using Appreciative Inquirer, Belinda Dewar’s Caring Conversations. The tools used to promote generative conversations about midwifery practice between the mentor and the mentee will be described. The NSW Health Midwifery Strategy aims to support midwifery leaders to respond to the needs of the profession now and into the future. MiM builds on previous work sponsored by the Nursing and Midwifery Office that revealed successful relationships between students and midwives was key to a sense of belonging and positive learning environments. Midwives valued the opportunity to provide a learning environment to students and recognised the importance of supporting our future workforce. A structured mentoring program was identified by midwives as an opportunity to strengthen the midwifery profession together. The intention of this work is to develop and implement an innovative and sustainable mentoring program that is transferable across all midwifery training and clinical facilities to become a normal part of midwifery culture in NSW. This program will support the midwifery profession, develop leadership at all levels and help in the retention of a strong, confident, and skilled midwifery workforce.

O74 - Support for midwives to practice with professional autonomy within their full scope of practice: Evidence from a scoping review

Midwives in Australia are educated and professionally accountable to practice in partnership with childbearing women and their families, yet most do not practice to their scope. There is an urgent need to review models of maternity care in Australia to facilitate growth in midwifery continuity of carer, relationship building, and partnership to optimise perinatal health and wellbeing, and to reduce midwifery burnout. This systematic scoping review of the literature maps the role and scope of contemporary midwifery practice in Australia to identify key issues that impact upon midwives practising to their full scope of practice. A scoping review guided by Arksey and O’Malley’s five-stage methodological framework, together with a ‘best fit’ framework synthesis using the Nursing and Midwifery Board of Australia’s Midwifery Standards for Practice. Following initial screening, 517 publications were retrieved, and with full text review evidence from 96 papers was included in this review. Key themes that emerged from the review included the central tenet of Partnership with women, facilitated by the Professional roles of the midwife, and mediated by Contextual influences . Tensions were identified between the midwifery scope of practice associated with optimal outcomes for women and babies supported by current evidence and the actual role and scope of most midwives employed in models of care in the current Australian public healthcare system. There is a mismatch between the operational parameters for midwifery practice in Australia and the evidence-based models of continuity of midwifery carer that are associated with optimal outcomes for childbearing women and babies and the midwives themselves. There is an urgent need to review the representation of the midwifery profession at leadership, executive and policy levels to support the role of the midwife to practice with professional autonomy within their full scope of practice.

Female Genital Mutilation: A Religio-Cultural Sensitive Issue Determining Maternal Health Care Choices among Somali Women in Dadaab Refugee Camp, Kenya

The paper addresses Kenya’s development challenges in maternal health care with a specific focus on the impact of traditional birth attendants (TBAs) and female genital mutilation (FGM) among the refugees. It purposes to achieve four objectives: to discuss the persistence of FGM among Somali women in Ifo Refugee Camp, to establish the hospital process of providing maternal health care to mothers who have gone through FGM; find out the level of preparedness of the midwives to handle mothers with religio- cultural concerns such as prayer, non-involvement of male nurses and how the practice of FGM contributes to the preference of TBA by mothers. The study assumes that midwives’ training may not have effectively addressed FGM, a social-cultural sensitive issue affecting childbirth and care. Secondly, the specific support of midwives in refugee camps contexts remains limited. A qualitative research approach was used in the study, involving Snowballing sampling method, in-depth interviews, and focus group discussions (FGDs). These methods brought out pertinent issues that make TBAs the preferential option for some mothers in spite of the presence of level 4 category hospitals in the refugee camps. In case of birth complications, the mother’s choice for TBA delays the family’s decision to take her to the hospital and for health care workers to save mother and child. The shortage of midwives and the presence of male midwives in hospitals make some Somali mothers seek assistance from TBAs. There is a need to contextualize midwifery training by enhancing the curriculum with evidence-based /mother-centered skills.

Female Genital Mutilation: A Religio-Cultural Sensitive Issue Determining Maternal Health Care Choices among Somali Women in Dadaab Refugee Camp, Kenya

The paper addresses Kenya’s development challenges in maternal health care with a specific focus on the impact of traditional birth attendants (TBAs) and female genital mutilation (FGM) among the refugees. It purposes to achieve four objectives: to discuss the persistence of FGM among Somali women in Ifo Refugee Camp, to establish the hospital process of providing maternal health care to mothers who have gone through FGM; find out the level of preparedness of the midwives to handle mothers with religio- cultural concerns such as prayer, non-involvement of male nurses and how the practice of FGM contributes to the preference of TBA by mothers. The study assumes that midwives’ training may not have effectively addressed FGM, a social-cultural sensitive issue affecting childbirth and care. Secondly, the specific support of midwives in refugee camps contexts remains limited. A qualitative research approach was used in the study, involving Snowballing sampling method, in-depth interviews, and focus group discussions (FGDs). These methods brought out pertinent issues that make TBAs the preferential option for some mothers in spite of the presence of level 4 category hospitals in the refugee camps. In case of birth complications, the mother’s choice for TBA delays the family’s decision to take her to the hospital and for health care workers to save mother and child. The shortage of midwives and the presence of male midwives in hospitals make some Somali mothers seek assistance from TBAs. There is a need to contextualize midwifery training by enhancing the curriculum with evidence-based /mother-centered skills.

‘Forgotten as first line providers’: The experiences of midwives during the COVID-19 pandemic in British Columbia, Canada

ObjectiveTo explore midwives’ experiences working on the frontlines of the COVID-19 pandemic in British Columbia, Canada. DesignQualitative study involving three semi-structured focus groups and four in-depth interviews with midwives. SettingThe COVID-19 pandemic in British Columbia, Canada from 2020-2021. Participants13 midwives working during the first year of the COVID-19 pandemic in British Columbia. FindingsQualitative analysis surfaced four key themes. First, midwives faced a substantial lack of support during the pandemic. Second, insufficient support was compounded by a lack of recognition. Third, participants felt a strong duty to continue providing high-quality care despite COVID-19 related restrictions and challenges. Lastly, lack of support, increased workloads, and moral distress exacerbated burnout among midwives and raised concerns around the sustainability of their profession. Key conclusions and implications for practiceLack of effective support for midwives during the initial months of the COVID-19 pandemic exacerbated staffing shortages that existed prior to the pandemic, creating detrimental gaps in essential care for pregnant people, especially with increasing demands for homebirths. Measures to support midwives should combat inequities in the healthcare system, mitigating the risks of disease exposure, burnout, and professional and financial impacts that may have long-lasting implications on the profession. Given the crucial role of midwives in women- and people-centred care and advocacy, protecting midwives and the communities they serve should be prioritized and integrated into pandemic preparedness and response planning to preserve women's health and rights around the world.

Factors influencing utilisation of services provided by community midwives and their non-retention in district Thatta, Pakistan: a qualitative study protocol

IntroductionDrawing on the well-acknowledged evidence of community midwives services to address the issue of high maternal mortality, the Government of Pakistan initiated the Community Midwifery (CMW) programme in 2006 to...

It's about finding a balance…exploring conscientious objection to abortion with UK midwives

BackgroundDespite the right for health professionals to abstain from providing abortion services existing for over 50 years, literature on conscientious objection to abortion scarcely mentions midwives. In addition, little empirical research has been carried out concerning midwives’ views surrounding what constitutes participation in abortion and in turn, what areas of care they can withdraw from. AimTo explore midwives’ beliefs regarding the extent of and limitations to the exercising of their legal right to objection to abortion on conscience grounds. DesignQualitative study with 17 midwives in Glasgow and Liverpool, UK. MethodFace to face semi-structured interviews, transcribed verbatim and analysed using a thematic analysis and Human Rights framework for midwifery care. FindingsThe extent of and limitations to CO to abortion-related care was reflected in four themes: respecting and protecting, making informed decisions, providing non-discriminatory care and experience and culture. There was an overriding sense of support for midwives to be able to exercise their right to conscientious objection, how this is operationalised in practice however continues to be fraught with complexity, which in turn poses constant challenges to midwives who object, their colleagues and managers. ConclusionsMidwives’ beliefs regarding the exercising of their legal right to object to abortion-related care on conscience grounds can be summarized in the challenge of “finding a balance”. A national picture of how to accommodate CO to abortion is needed, so that all midwives can continue to give optimal care to women and receive it themselves, within a human rights framework.