Presentation Information

Perinatal mood and anxiety disorders (PMADs) include a spectrum of commonly-occuring mental health disorders. About 17% of postpartum mothers worldwide experience depression, with rates climbing to 60% in some low social-economic status women and adolescent mothers. However, less well-known PMADs include perinatal panic disorder, perinatal obsessive-compulsive disorder (OCD), and perinatal post-traumatic stress disorder (PTSD). These often include very distressing intrusive or bizarre thoughts, behaviors, or flashbacks.

Perinatal bipolar disorder and postpartum psychosis are particularly dangerous due to severe depression, and reckless or bizarre behavior that can endanger mother and baby. Women with bipolar disorder may have stopped medications during pregnancy and are experiencing mood instability. They may also not realize they have bipolar disorder and require careful diagnosis, since twenty-two percent of depressed women postpartum have bipolar depression.

Postpartum psychosis is an emergency and occurs in 1 to 2 of every 1,000 deliveries. This requires immediate hospitalization for safety, due to a 5% suicide rate and 4% infanticide rate. The midwife is part of the safety net for postpartum mothers and is a vital first step for identifying possible PMADs and referring the mother for mental health treatment and support.

Pregnancy related pelvic girdle pain (PPGP) is a common presentation representing a significant health problem in perinatal care. Although the etiology of PPGP is yet to be fully elucidated, the state of the science regarding PPGP has evolved substantially over the last decade. Despite this, care of PPGP remains poor as the the uptake of this evolution remains limited. Increasingly, PPGP is associated with significant maternal morbidity extending to implications for the whole family unit. As such, PPGP should be regarded as a priority among all relevant health care professionals and such professionals need themselves to be up to date with current research in order to optimally assist those they care for.

Despite recent clinical practice guidelines acknowledging the need to shift away from viewing this pain presentation through a biomechanical lens, the biomechanical narrative remains and is to the detriment of those with PPGP. The majority of currently utilized care strategies for PPGP are not supported by current clinical practice guidelines or recommended practice perspectives. The impetus of the recent publication of “Reframing beliefs and instilling facts for contemporary management of pregnancy-related pelvic girdle pain”, with associated infographic, was to facilitate the needed knowledge mobilization on this topic. This presentation will allow you to update your practices to align with recent research and new recommendations for best practice.

Aromatherapy in Midwifery Practice: Clinical Pearls" will highlight the most important uses for aromatherapy during the perinatal period, from the moment of conception through the first month of postpartum. This discussion will begin with a short introduction to aromatherapy which will include the primary methods of essential oil application, a brief overview of why aromatherapy is an effective natural therapy, and key safety considerations that are unique for use during maternity.

Following the introduction, for each specific indication discussed, participants will learn the recommended method of application, essential oil options, safety considerations, dilution ratios, and frequency of application. These "clinical pearl" guidelines will be derived from overlapping evidence-based research, anecdotal evidence, and personal experience to ensure both safe and effective use. The presentation will end with practical advice on how to walk away being able to safely and effectively apply essential oils for at least 10 specific indications that are common during pregnancy, birth and postpartum.

In this presentation I will explore the latest evidence and issues around Vaginal Birth After Caesarean (VBAC) internationally and then focus in on new research about supporting women planning a VBAC.

The four factors that impact how women feel about their birthing experience will be explored with a focus on how health care providers can use these factors to provide the best support for women and birthing people planning a birth after caesarean.

Breast milk is a diverse array of immunological components, such as antibodies, cytokines, growth factors, and immune cells. These maternal immune factors can prevent infections and promote immune tolerance in the neonate. Antibodies, particularly secretory immunoglobulin A (IgA), provide a first line of defense at the mucosal surfaces of the infant's gastrointestinal and respiratory tracts, offering protection against many infectious organisms. Beyond direct pathogen defense, breast milk immunology influences neonatal health through various mechanisms. Maternal immune factors modulate immune development by promoting the maturation of immune cells and aiding in the establishment of the infant microbiome.

These processes have been associated with protection against autoimmune diseases and allergies as well as improved nutrient absorption and reduced risk of gastrointestinal disorders. However, breast milk is still an understudied immunological compartment and there is much to be learned about human breast milk and its role in neonatal health. This presentation will define the immunological components in breast milk, the scientific evidence of breast milk's protective potential and the gaps in knowledge. Understanding and harnessing the power of breast milk's immune-boosting properties can pave the way for interventions that enhance neonatal health outcomes and lay the foundation for a healthier future.

Perinatal mood and anxiety disorders (PMADs) include a spectrum of commonly-occuring mental health disorders. About 17% of postpartum mothers worldwide experience depression, with rates climbing to 60% in some low social-economic status women and adolescent mothers. However, less well-known PMADs include perinatal panic disorder, perinatal obsessive-compulsive disorder (OCD), and perinatal post-traumatic stress disorder (PTSD). These often include very distressing intrusive or bizarre thoughts, behaviors, or flashbacks. Perinatal bipolar disorder and postpartum psychosis are particularly dangerous due to severe depression, and reckless or bizarre behavior that can endanger mother and baby.

Women with bipolar disorder may have stopped medications during pregnancy and are experiencing mood instability. They may also not realize they have bipolar disorder and require careful diagnosis, since twenty-two percent of depressed women postpartum have bipolar depression. Postpartum psychosis is an emergency and occurs in 1 to 2 of every 1,000 deliveries. This requires immediate hospitalization for safety, due to a 5% suicide rate and 4% infanticide rate. The midwife is part of the safety net for postpartum mothers and is a vital first step for identifying possible PMADs and referring the mother for mental health treatment and support.

Asthma is the most common chronic medical condition to affect pregnancy. For example, in Australia 12.7% of pregnant women have asthma. Poorly controlled asthma leading to exacerbation of symptoms can lead to poor maternal and neonatal outcomes such as preterm birth and low birth weight babies. Asthma in pregnancy can be unpredictable in that approximately 1/3 of women experience a worsening of their asthma symptoms with the other two thirds either experiencing an improvement of their asthma symptoms or no change. Recommendations for the management of asthma during pregnancy is clearly stated in clinical practice guidelines.

These include regular review of asthma symptoms, having a multidisciplinary team approach to management, ensuring ongoing prescribed medication use and having an asthma action plan. Previous research has identified the need for improved knowledge and awareness of asthma in pregnancy among health professionals and pregnant women. Innovative management techniques and educational resources are being developed and implemented to continue to meet these needs and to improve the outcomes for women and babies whose pregnancy is affected by asthma.

Wanting to be heard is a normal human need. This need to be listened to, validated and understood is especially strong when a birth does not go the way the birthing parent had hoped. When parents do not feel seen, it can lead to trauma that can have a powerful impact during the vulnerable period after birth. This presentation explores the importance and nuances of debriefing following a traumatic or difficult perinatal experience.

Highlighting causes of trauma, importance of trauma informed care, the value of debriefing as well as discussing the risks of trauma and the contributors to perinatal trauma and how they can be avoided. Included are tips on reflection including how to, when and with whom, along with advice on when and how to signpost and discussion around debriefing for healthcare professionals.

Gestational diabetes affects around 20 million patients per year internationally, with long-term consequences for the health of mother and child. Women with gestational diabetes are at increased risk of pre-eclampsia, perinatal trauma and operative delivery, and are more likely to develop type 2 diabetes (T2D) and cardiovascular disease (CVD) in later life. Affected offspring are at increased risk of obesity, insulin resistance and metabolic syndrome in childhood and adolescence. The lack of a standardized diagnostic pathway internationally and inadequate access to treatment creates real challenges in optimizing care for affected women and their children. Gestational diabetes is managed using medical nutrition therapy, metformin and/or insulin. After pregnancy, women should be screened for the development of diabetes. Longer-term interventions are needed to reduce the risk of T2D postnatally. The aim of this presentation is to discuss the causes, treatment and longer-term management of patients with gestational diabetes. We will focus on the use of nutritional advice, medication and lifestyle changes on gestational diabetes incidence and management. We will outline key strategies for preventing T2D in affected patients after gestational diabetes and highlight the role of breastfeeding in improving women’s longer-term metabolic health.

Hypertension in pregnancy is a global public health threat complicating approximately 2-3% of pregnancies worldwide. The hypertensive spectrum ranges from mild, essential, or gestational hypertension to severe disease including the pre-eclampsia spectrum, HELLP syndrome, and eclampsia. These hypertensive disorders account for approximately 50,000 maternal deaths worldwide and have become a leading cause of maternal mortality. The incidence of hypertensive disorders of pregnancy has also increased worldwide, disproportionately affecting pregnant people of color. Staying up to date with the latest research and thoughts on best practice for identification of disease and clinical management of hypertension in pregnancy can prepare practitioners to efficiently identify and treat pregnant people with hypertension thereby reducing complications and improving maternal and fetal mortality and morbidity rates.

We exist on this planet because of the vital metals like sodium, potassium, magnesium, and calcium that easily dissolve in our body's water. Equally important are iron, zinc, and copper, found in nearly half of our proteins.

Iron plays a crucial role in our blood, with four iron atoms in hemoglobin storing and transporting oxygen. Inadequate iron in early childhood leads to reduced attention span, difficulty grasping concepts, irritability, social withdrawal, and delays in language and motor skills. Iron deficiency during pregnancy increases the risk of premature birth, low birth weight, birth asphyxia, maternal infections, pre-eclampsia, and hemorrhage.

Approximately two billion people or 25% of the global population lack sufficient dietary iron and iron stores. Anemia (the last stage of iron deficiency) caused 50 million years of healthy life lost due to disability in 2019 alone. This presentation aims to educate healthcare providers and birth workers on the magnitude of this epidemic and provide guidance on the essential laboratory assessments, symptoms and the new evidenced-based values for evaluating iron status in patients. It will also cover important aspects of proper treatment approaches.

Botanical medicine options are utilized by over 80% of our global population as a form of primary care. Many individuals report wanting to consider using herbs in pregnancy and beyond but are often unsure what is safe or appropriate. Clinicians play an essential role in helping individuals understand the risks and benefits of herbs for mood support in the perinatal period. By identifying meaningful resources and reliable information around botanical options, health professionals can empower families to make safe, informed choices. “Nature’s Nurturers” critically examines the use of herbal options to support perinatal mood concerns such as anxiety and depression. This talk focuses on the foundational need for individualized support when it comes to botanical discussion and selection.

Early detection and addressing of potential breastfeeding issues is known to improve breastfeeding outcomes. Assessment and counselling of pregnant parents must begin prenatally, preferably during each prenatal check-up, in order to detect and foresee common preventable breastfeeding problems.

Depending on whether the potential red flags are anatomical, metabolic, psychological, social or cultural, health care professionals responsible for prenatal and immediate postnatal care of the parent-baby dyad can play a significant role in helping them overcome the hurdles to successful breastfeeding by targeted counselling.

Existing health issues or those that surface during pregnancy; previous fertility, birthing, breastfeeding and parenting experience; home and work situation, self-efficacy, etc. are some of the factors which may pose breastfeeding challenges. Anticipatory guidance can go a long way in enabling parents to be better equipped to deal with such challenges as they arise, to ensure long term breastfeeding success.

Somatic Movement is an exploratory field that invites phenomenological exploration, or an in-depth focus on the nuances and perceptions of the body from within, to promote sustained positive change. Midwifery refers to the provision of clinical care that safeguards childbirth and the continuums before, after and in lieu of childbearing as normal events; while centering the informed choices, preferences, and values of each care-seeking individual; minimizing unnecessary intervention; and working autonomously within an integrated interprofessional team.

This session will explore how one midwife, across an array of global contexts and settings, has infused these two fields to become one. Explorations will include applications of Somatic Movement in midwifery using examples from client care, midwifery education, provider development, advocacy and leadership development. Participants will leave this session with a baseline understanding of Somatics and, with concepts like experiential anatomy, therapeutic touch, movement patterns, authentic movement, and elements from craniosacral therapy woven across the session, equipped with somatic concepts ready to be used irrespective of the direction of their greatest force, whether through practice, teaching, advocacy, or leadership.

In 1903, Whitridge Williams declared “A characteristic sign of impending asphyxia is the escape of meconium”. It’s unlikely this statement was founded on robust, peer-reviewed research, though there has since been research a-plenty based on the underlying inference that in-utero meconium passage is associated with poorer outcomes. Had researchers instead begun with questioning if meconium is indeed an independent marker for those poorer outcomes, then we may nowadays have a better understanding of why most infants with a poor outcome do not pass meconium in labour (Greenwood et al 2003) and most babies exposed to meconium liquor are born in good condition.

Using the findings from an extensive review of the literature, this presentation will begin by exploring the theories of meconium passage. It will review the research that is currently shaping our meconium guidelines (meconium as pathological) and analyse the data that supports the concept of meconium passage as a physiological, i.e., ‘normal’, event. Then, using the evidence, it will critique the current assessment and management practices of meconium labours and infants born through meconium. Does meconium deserve its reputation as an omen for poor outcomes? Or have we been unjustly scared meconiumless??

This presentation will discuss the importance of midwives being an integral stakeholder in the systems-level response practices for intimate partner violence (IPV). We will identify clinical presentations of exposure to violence during childbearing, responder-inflicted harms, and barriers and facilitators to help-seeking. Next we will develop an understanding of how midwives can play a crucial role in decreasing re-victimization, morbidity, and mortality by responding with a survivor-centered approach. This presentation uses a social justice lens that addresses the complexities of IPV-related outcomes for marginalized individuals, offering actionable ways to use the midwifery model of care for individual needs by engaging a range of community-facing services.

Family members and other support people are an important part of the birth experience but what do we do when their behaviour is disruptive for the birthing parent? Family centered maternity care means caring not just for the person in labour, but also for those they have chosen to be in the birth room for support. Join us for an engaging panel discussion that will explore the potential reasons for disruptive behaviour from family members, the impact of the midwife’s own emotional regulation and helpful strategies for turning family members and other support people in the birth room into supportive allies.