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I will address seven questions. (1) Why we should engage fathers? (2) What does the World Health Organisation say on this? (3) What are the needs and motivations of fathers? (4) What biological and brain changes take place in men when they cuddle a baby? (5) What difference does engaging fathers make to health outcomes for mother and baby? (6) How to organise engagement with fathers in a health service? (7) Why is it so difficult to maintain strong engagement with fathers?

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12-02-2019 19:00 12-02-2019 20:00 35 Engaging Fathers in Maternity Care I will address seven questions. (1) Why we should engage fathers? (2) What does the World Health Organisation say on this? (3) What are the needs and motivations of fathers? (4) What biological and brain changes take place in men when they cuddle a baby? (5) What difference does engaging fathers make to health outcomes for mother and baby? (6) How to organise engagement with fathers in a health service? (7) Why is it so difficult to maintain strong engagement with fathers? GOLD Perinatal Online Conference false DD/MM/YYYY

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Nausea and vomiting in pregnancy remain one of the most persistent and frustrating problems for both expectant mothers and their prenatal care providers. Forty percent or more of women will experience symptoms beyond the first trimester. Evidence for first-line pharmacologic treatments as well as off-label and botanical medicines is discussed, along with efficacy, risks, benefits, and the shared decision-making process in selecting a treatment. Outcomes, prognosis, and treatment of special populations are examined.

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12-02-2019 20:00 12-02-2019 21:00 35 Evidence-based Pharmacologic Management of Nausea and Vomiting in Pregnancy Nausea and vomiting in pregnancy remain one of the most persistent and frustrating problems for both expectant mothers and their prenatal care providers. Forty percent or more of women will experience symptoms beyond the first trimester. Evidence for first-line pharmacologic treatments as well as off-label and botanical medicines is discussed, along with efficacy, risks, benefits, and the shared decision-making process in selecting a treatment. Outcomes, prognosis, and treatment of special populations are examined. GOLD Perinatal Online Conference false DD/MM/YYYY

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The Ehlers-Danlos Syndromes (EDS) are inherited multi-systemic conditions affecting all connective tissues. Those affected perceive a lack of understanding. Hypermobile EDS (hEDS) is the most common subtype, with significant implications for childbearing women, for whom it is more common. This seminar will present and discuss evidence-based maternity care considerations for this unique subgroup of childbearing women, derived from a recent review of the evidence and an international qualitative study. Greater understandings could translate into practical improvements within maternity care, and a reduction in physical trauma and psychological distress for those with hEDS. Participants are invited to actively engage in critical thinking, practical solutions planning and translating this research into real and positive improvements for maternity services.

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11-02-2019 14:00 11-02-2019 15:00 35 Exploring the Needs of Childbearing Women with Hypermobile Ehlers-Danlos Syndrome (hEDS) The Ehlers-Danlos Syndromes (EDS) are inherited multi-systemic conditions affecting all connective tissues. Those affected perceive a lack of understanding. Hypermobile EDS (hEDS) is the most common subtype, with significant implications for childbearing women, for whom it is more common. This seminar will present and discuss evidence-based maternity care considerations for this unique subgroup of childbearing women, derived from a recent review of the evidence and an international qualitative study. Greater understandings could translate into practical improvements within maternity care, and a reduction in physical trauma and psychological distress for those with hEDS. Participants are invited to actively engage in critical thinking, practical solutions planning and translating this research into real and positive improvements for maternity services. GOLD Perinatal Online Conference false DD/MM/YYYY

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Humanising birth is an approach that recognises the significance of birth not only to the baby being born, the woman becoming mother, and her family, but also to society. Humanisation of birth goes beyond a focus on medical care and simply reducing mortality and morbidity. Humanisation of birth aims to give the best start in life; supports reduction of the excessive medicalization of birth, while ensuring appropriate and balanced medical care is accessible to all women, their babies and families. We will consider the wider politics, international and national, the status of women, developing health services policy and organization, human rights in birth, broadening our science base to include all relevant evidence, and the development of humanised maternity systems and practice. Moving from broad views to focus on practice will provide the opportunity to think, reflect, develop ideas and to act, for everyone involved in maternity care.

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25-02-2019 17:00 25-02-2019 18:15 35 Humanising Birth Humanising birth is an approach that recognises the significance of birth not only to the baby being born, the woman becoming mother, and her family, but also to society. Humanisation of birth goes beyond a focus on medical care and simply reducing mortality and morbidity. Humanisation of birth aims to give the best start in life; supports reduction of the excessive medicalization of birth, while ensuring appropriate and balanced medical care is accessible to all women, their babies and families. We will consider the wider politics, international and national, the status of women, developing health services policy and organization, human rights in birth, broadening our science base to include all relevant evidence, and the development of humanised maternity systems and practice. Moving from broad views to focus on practice will provide the opportunity to think, reflect, develop ideas and to act, for everyone involved in maternity care. GOLD Perinatal Online Conference false DD/MM/YYYY

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During birth pain remains a central issue, > 85% of mothers are still tearing their pelvic tissues, 30% push for 2 hours or more, and 10% fail to progress despite reaching the 2nd stage. Central to achieving this is the need for training on birth positioning physiology to be more formalized and academic. As this will show our fixation on the upright position can be as detrimental to progress and cause more long-term trauma than the supine position. Most of the literature and teaching remains rooted in basic terminology that does not fully address the true physiology of birth positioning and the latest research contradicts the holistic benefits of the upright position. Using unique visual animations you will learn a unique approach that will help you understand how the creation of positive or negative pressures influence outcomes. Things that we desperately need to know about birth positioning that is rarely taught in obstetric or midwifery schools, and why one particular practice > 95% of mothers are encouraged to do in the 2nd stage, is the biggest public heath crisis of our time. Creating prolapse, incontinence, diastasis and trauma to the baby etc.

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19-02-2019 18:00 19-02-2019 19:00 35 It Is Time To Go Beyond Upright Birth Positioning! How To Prevent Abuse, Pain, Intervention, and Perineal/Pelvic Tears In The Second Stage During birth pain remains a central issue, > 85% of mothers are still tearing their pelvic tissues, 30% push for 2 hours or more, and 10% fail to progress despite reaching the 2nd stage. Central to achieving this is the need for training on birth positioning physiology to be more formalized and academic. As this will show our fixation on the upright position can be as detrimental to progress and cause more long-term trauma than the supine position. Most of the literature and teaching remains rooted in basic terminology that does not fully address the true physiology of birth positioning and the latest research contradicts the holistic benefits of the upright position. Using unique visual animations you will learn a unique approach that will help you understand how the creation of positive or negative pressures influence outcomes. Things that we desperately need to know about birth positioning that is rarely taught in obstetric or midwifery schools, and why one particular practice > 95% of mothers are encouraged to do in the 2nd stage, is the biggest public heath crisis of our time. Creating prolapse, incontinence, diastasis and trauma to the baby etc. GOLD Perinatal Online Conference false DD/MM/YYYY

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Up to 30% of women experience severe back pain in labour. In qualitative studies women have described how labour back pain limited their mobility and altered their plans for analgesia use. Injections of small amounts of sterile water into the skin of the lower back are used to alleviate back pain for up to two hours. Whilst much research supports the effectiveness of the technique critics suggest a placebo effect or dismiss the procedure as ‘midwifery voodoo’. This presentation will examine the causes and physiology of back pain in labour, examine and critique the research into sterile water injections and describe the techniques, benefits and limitations for use in clinical practice.

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13-02-2019 00:00 13-02-2019 01:00 35 Managing Back Pain in Labour Using Sterile Water Injections Up to 30% of women experience severe back pain in labour. In qualitative studies women have described how labour back pain limited their mobility and altered their plans for analgesia use. Injections of small amounts of sterile water into the skin of the lower back are used to alleviate back pain for up to two hours. Whilst much research supports the effectiveness of the technique critics suggest a placebo effect or dismiss the procedure as ‘midwifery voodoo’. This presentation will examine the causes and physiology of back pain in labour, examine and critique the research into sterile water injections and describe the techniques, benefits and limitations for use in clinical practice. GOLD Perinatal Online Conference false DD/MM/YYYY

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A simple and effective mindfulness and meditation program, designed for midwives to use for themselves and teach to their clients, is presented. Stress can contribute to and certainly exacerbates nearly all pregnancy, labor, and postpartum health issues and complications. Yet, there is little regarding stress management included in midwifery texts. Midwives may feel ill equipped to assist clients in dealing with generalized stress. Further, midwives themselves may lack the tools to moderate their own stress levels that naturally result from the demands of midwifery. Studies show that mindfulness and meditation both have the effect of reducing stress, and, in some cases, have improved clinical outcomes in patients. Both mindfulness and meditation will be discussed, and participants will leave with a downloadable, small-scale daily mindfulness and meditation PDF program, utilizing proven stress-management techniques, designed to be easily implemented, both by midwife and client. Participants will be invited to engage in practice of these techniques, throughout the presentation.

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11-02-2019 18:00 11-02-2019 19:00 35 Mindfulness & Meditation for Midwives & Mamas A simple and effective mindfulness and meditation program, designed for midwives to use for themselves and teach to their clients, is presented. Stress can contribute to and certainly exacerbates nearly all pregnancy, labor, and postpartum health issues and complications. Yet, there is little regarding stress management included in midwifery texts. Midwives may feel ill equipped to assist clients in dealing with generalized stress. Further, midwives themselves may lack the tools to moderate their own stress levels that naturally result from the demands of midwifery. Studies show that mindfulness and meditation both have the effect of reducing stress, and, in some cases, have improved clinical outcomes in patients. Both mindfulness and meditation will be discussed, and participants will leave with a downloadable, small-scale daily mindfulness and meditation PDF program, utilizing proven stress-management techniques, designed to be easily implemented, both by midwife and client. Participants will be invited to engage in practice of these techniques, throughout the presentation. GOLD Perinatal Online Conference false DD/MM/YYYY

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Naturopathic medicine is a holistic, patient centered approach to healthcare. Expanding our tool bag to assist women in labor and delivery will be helpful knowledge for all midwives to attain. In this lecture, we will delve deep into naturopathic medicine for labor. We will detail herbal medicines for ease of delivery, induction, and delayed labor including specific indications and dosages. Homeopathic remedies with specific indications and dosages along with other holistic health care modalities for delivery and labor will be taught. We will also touch on herbal medicine and homeopathy for hemorrhage and perineal care.

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19-02-2019 20:00 19-02-2019 21:00 35 Naturopathics in Labor Naturopathic medicine is a holistic, patient centered approach to healthcare. Expanding our tool bag to assist women in labor and delivery will be helpful knowledge for all midwives to attain. In this lecture, we will delve deep into naturopathic medicine for labor. We will detail herbal medicines for ease of delivery, induction, and delayed labor including specific indications and dosages. Homeopathic remedies with specific indications and dosages along with other holistic health care modalities for delivery and labor will be taught. We will also touch on herbal medicine and homeopathy for hemorrhage and perineal care. GOLD Perinatal Online Conference false DD/MM/YYYY

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Increased cannabis liberalization has resulted in a more active conversation about perinatal cannabis use, but globally, research and policy perspectives vary dramatically. This presentation will provide a summary of the endocannabinoid system, international rates of perinatal cannabis use, and varying beliefs about the use of cannabis as medicine across the globe. We will explore the published research on the potential health effects of perinatal cannabis use, highlighting physiologic harm reduction strategies. Beyond the health implications, we will discuss the relationship between professional organizational recommendations and the care pregnant and lactating families receive when healthcare policies reflect an abstinence-only approach. Any risk/benefit analysis about perinatal cannabis use should include the potential for significant legal and governmental intervention, which has its own set of outcomes and implications. Finally, the emerging science of high CBD/low THC products will be presented with an eye towards understanding the potential implications of perinatal CBD use.

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12-02-2019 22:00 12-02-2019 23:00 35 Perinatal Cannabis Use Around the Globe: Research, Policy and Legal Implications Increased cannabis liberalization has resulted in a more active conversation about perinatal cannabis use, but globally, research and policy perspectives vary dramatically. This presentation will provide a summary of the endocannabinoid system, international rates of perinatal cannabis use, and varying beliefs about the use of cannabis as medicine across the globe. We will explore the published research on the potential health effects of perinatal cannabis use, highlighting physiologic harm reduction strategies. Beyond the health implications, we will discuss the relationship between professional organizational recommendations and the care pregnant and lactating families receive when healthcare policies reflect an abstinence-only approach. Any risk/benefit analysis about perinatal cannabis use should include the potential for significant legal and governmental intervention, which has its own set of outcomes and implications. Finally, the emerging science of high CBD/low THC products will be presented with an eye towards understanding the potential implications of perinatal CBD use. GOLD Perinatal Online Conference false DD/MM/YYYY

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This session addresses the competencies midwives need to manage complications and emergencies regardless of the situation, and when or where it occurs. How do we prepare for the many possibilities that can come a midwife’s way and feel confident in our abilities to think on our feet and work together for optimal outcomes? How do we improve our teamwork and ability to respond? After an emergency is over, what tools can we use to evaluate how to improve our practice? How do we heal our own trauma? We will take a look at ways to answer these questions with a focus on improving communication, teamwork, and leadership skills.

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11-02-2019 16:00 11-02-2019 17:00 35 Ready, Response-able, Resilient; Handling Complications & Emergencies This session addresses the competencies midwives need to manage complications and emergencies regardless of the situation, and when or where it occurs. How do we prepare for the many possibilities that can come a midwife’s way and feel confident in our abilities to think on our feet and work together for optimal outcomes? How do we improve our teamwork and ability to respond? After an emergency is over, what tools can we use to evaluate how to improve our practice? How do we heal our own trauma? We will take a look at ways to answer these questions with a focus on improving communication, teamwork, and leadership skills. GOLD Perinatal Online Conference false DD/MM/YYYY

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Midwives are among the health professionals who provide care early during a humanitarian emergency and stay on for the long term. Women and children become significantly at risk of various reproductive morbidities during crises and are of greatest concern to midwives. Nurse midwives play an important role in women’s access to reproductive and maternal health services all over the world especially at the periphery of the health care system where there are no doctors. Midwives are more so needed in areas like Bangladesh where over 90 percent of the population lives in rural areas. To this end, the global community has a duty in the development of the midwifery profession. After all the nursing & midwifery philosophy of caring for individuals, families and communities in need places us in a better position to be actively involved with populations affected by crisis. Nurses and midwives are frontline workers and provide a wide range of health services, which include promotive, preventive, curative, rehabilitative and supportive care to individuals, families and groups.

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19-02-2019 22:00 19-02-2019 23:00 35 Role of Midwives in Humanitarian Crisis Midwives are among the health professionals who provide care early during a humanitarian emergency and stay on for the long term. Women and children become significantly at risk of various reproductive morbidities during crises and are of greatest concern to midwives. Nurse midwives play an important role in women’s access to reproductive and maternal health services all over the world especially at the periphery of the health care system where there are no doctors. Midwives are more so needed in areas like Bangladesh where over 90 percent of the population lives in rural areas. To this end, the global community has a duty in the development of the midwifery profession. After all the nursing & midwifery philosophy of caring for individuals, families and communities in need places us in a better position to be actively involved with populations affected by crisis. Nurses and midwives are frontline workers and provide a wide range of health services, which include promotive, preventive, curative, rehabilitative and supportive care to individuals, families and groups. www.GOLDMidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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This presentation traces how national and international efforts to improve childbirth care have graduated from disenfranchised social movements in the 1970s and 1980s to entrenchment of human rights in childbirth in UN declarations and the courts. Dynamic communities around the world that are rejecting the imposition of status quo dysfunctional pregnancy and childbirth systems and replacing them with more appropriate models of care will be highlighted. Using unorthodox means, such as employing non physicians to do cesareans, placing a psychologist instead of an obstetrician in charge of the caseroom, choosing to support instead of arrest and eliminate the traditional midwives, I present these iconoclastic models that work even under dire circumstances, in countries as diverse as China, Canada, India, Afghanistan, Turkey, Hungary, Tanzania, Palestine and Mexico. Tackling the problems of the neoliberal drive for privatization and centralization of health care services and the bullying between and among the professions, I demonstrate how the use of radical, conscious change in birth practices, puts practitioners at their peril who choose to take their stand with childbearers, but places power and control in the right hands.

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04-02-2019 17:00 04-02-2019 18:15 35 Speaking Truth to Power: Childbirth Models on the Human Rights’ Frontier This presentation traces how national and international efforts to improve childbirth care have graduated from disenfranchised social movements in the 1970s and 1980s to entrenchment of human rights in childbirth in UN declarations and the courts. Dynamic communities around the world that are rejecting the imposition of status quo dysfunctional pregnancy and childbirth systems and replacing them with more appropriate models of care will be highlighted. Using unorthodox means, such as employing non physicians to do cesareans, placing a psychologist instead of an obstetrician in charge of the caseroom, choosing to support instead of arrest and eliminate the traditional midwives, I present these iconoclastic models that work even under dire circumstances, in countries as diverse as China, Canada, India, Afghanistan, Turkey, Hungary, Tanzania, Palestine and Mexico. Tackling the problems of the neoliberal drive for privatization and centralization of health care services and the bullying between and among the professions, I demonstrate how the use of radical, conscious change in birth practices, puts practitioners at their peril who choose to take their stand with childbearers, but places power and control in the right hands. GOLD Perinatal Online Conference false DD/MM/YYYY

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Sub-Saharan Africa has experienced little improvement in maternity outcomes in recent years (World Health Organization[WHO], 2014) and yet, in an informal settlement in Nairobi, where the urban poor suffer the greatest losses of mothers and babies (Ndirangu, 2015; Ziraba, Madise, Mills, Kyobutungi, & Ezeh, 2009), one place stands out.

“An equal chance at life and love”.
This phrase is embedded into the vision of the not-for-profit, privately-run Fremo Birth Centre(FBC).
Although under-staffed and under-resourced, the FreMo Birth Centre provides
o  free/small cost maternity care focusing on normal birth, including breech, twins, VBAC.
o  well baby/well woman/family planning/post abortion care.
o  zero maternal mortality or serious injury (including no 3rddegree tears or beyond)
o  neonatal morbidity/mortality far below national figures.
(Fremo Medical and Birth Centre, 2011-2017; WHO, 2014).
On behalf of those heroes who run the centre on a day-to-day basis, I am honoured to tell their story. Vicki Chan

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19-02-2019 22:00 19-02-2019 23:00 35 The Story of the FreMo Birth Centre. Midwifery Care in a Low Resource Setting. Sub-Saharan Africa has experienced little improvement in maternity outcomes in recent years (World Health Organization[WHO], 2014) and yet, in an informal settlement in Nairobi, where the urban poor suffer the greatest losses of mothers and babies (Ndirangu, 2015; Ziraba, Madise, Mills, Kyobutungi, & Ezeh, 2009), one place stands out. “An equal chance at life and love”. This phrase is embedded into the vision of the not-for-profit, privately-run Fremo Birth Centre(FBC). Although under-staffed and under-resourced, the FreMo Birth Centre provides o  free/small cost maternity care focusing on normal birth, including breech, twins, VBAC. o  well baby/well woman/family planning/post abortion care. o  zero maternal mortality or serious injury (including no 3rddegree tears or beyond) o  neonatal morbidity/mortality far below national figures. (Fremo Medical and Birth Centre, 2011-2017; WHO, 2014). On behalf of those heroes who run the centre on a day-to-day basis, I am honoured to tell their story. Vicki Chan GOLD Perinatal Online Conference false DD/MM/YYYY

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New global standards highlight the critical impact of patient-provider communication, emotional support, and respectful care (RMC) on quality and safety for mothers and newborns. Yet, very little is known about how people experience maternity care in high and middle resource countries; and validated indicators of RMC are scarce.

Researchers have proposed that institutional racism and lack of access to autonomy and respect, and physiologic birth options, contribute to adverse outcomes. Community members in Canada and the US worked with clinicians, NGO leaders, and researchers to design a study on quality of maternity care as experienced by pregnant persons from communities that experience higher rates of adverse outcomes due to race (African American, Indigenous, and Latina), immigrant or refugee status, or social barriers (homelessness, incarceration, substance use). Together they developed and administered a cross-sectional online survey and convened focus groups to explore novel topics including: women’s experiences of agency in decision-making, non-consented care, access to supportive services, and systemic respect or discrimination over the course of care.

Through these large community-based participatory research projects, we validated three new quality measures, the Mother’s Autonomy in Decision Making (MADM) scale and the Mothers on Respect (MORi) index, and the Pregnant Persons Experience of Mistreatment by Providers (PPEMP) Index, and adapted a fourth, the Perceptions of Racism scale. Using these as indicators, and adjusting for differences in socio-demographics, risk profile, type of provider, and place of birth, our multi-stakeholder team has completed descriptive, psychometric, regression, and mixed-effects analysis of data from over 5000 women in the US and Canada.

In this session we will explore how these reports of the lived experience of care can help us to understand how to address equitable access to the highest quality of care across all communities.

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11-02-2019 20:00 11-02-2019 21:00 35 “They Threatened and Bullied Me”: Examining Disparities in Autonomy, Respect, and Mistreatment Across Childbearing Communities New global standards highlight the critical impact of patient-provider communication, emotional support, and respectful care (RMC) on quality and safety for mothers and newborns. Yet, very little is known about how people experience maternity care in high and middle resource countries; and validated indicators of RMC are scarce. Researchers have proposed that institutional racism and lack of access to autonomy and respect, and physiologic birth options, contribute to adverse outcomes. Community members in Canada and the US worked with clinicians, NGO leaders, and researchers to design a study on quality of maternity care as experienced by pregnant persons from communities that experience higher rates of adverse outcomes due to race (African American, Indigenous, and Latina), immigrant or refugee status, or social barriers (homelessness, incarceration, substance use). Together they developed and administered a cross-sectional online survey and convened focus groups to explore novel topics including: women’s experiences of agency in decision-making, non-consented care, access to supportive services, and systemic respect or discrimination over the course of care. Through these large community-based participatory research projects, we validated three new quality measures, the Mother’s Autonomy in Decision Making (MADM) scale and the Mothers on Respect (MORi) index, and the Pregnant Persons Experience of Mistreatment by Providers (PPEMP) Index, and adapted a fourth, the Perceptions of Racism scale. Using these as indicators, and adjusting for differences in socio-demographics, risk profile, type of provider, and place of birth, our multi-stakeholder team has completed descriptive, psychometric, regression, and mixed-effects analysis of data from over 5000 women in the US and Canada. In this session we will explore how these reports of the lived experience of care can help us to understand how to address equitable access to the highest quality of care across all communities. GOLD Perinatal Online Conference false DD/MM/YYYY

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