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The impact of poor perinatal outcomes and racial disparities on women, their families and the community at large. What are the causes and who suffers disproportionately?

The JJ Way ®

How has the JJ Way® model of prenatal care made a difference? The 2007, 2014, 2017 Study –evaluation results What is lacking in ‘Materno-toxic Areas’ and maternity healthcare? What do we need now?

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26-02-2018 17:00 26-02-2018 18:15 35 Where There's A Will, There's A Way! Midwifery as a model for reducing racial disparities, building community and creating revenue The impact of poor perinatal outcomes and racial disparities on women, their families and the community at large. What are the causes and who suffers disproportionately? The JJ Way ® How has the JJ Way® model of prenatal care made a difference? The 2007, 2014, 2017 Study –evaluation results What is lacking in ‘Materno-toxic Areas’ and maternity healthcare? What do we need now? www.GOLDmidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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Biological nurturing (BN), a mother-led approach, promotes body contact even when the baby is asleep. BN theories link hormonal continuity from pregnancy to postpartum and reflex continuity from womb to world. During the last weeks of pregnancy, oxytocin levels rise, peaking immediately following birth. Early baby gazing and eye-to-eye contact help maintain this high oxytocin pulsatility associated with increased breastfeeding duration. Experts in Body-Mind Centering suggest that fetal reflexes radiate from the navel--- the core, thus preparing neonatal movement. Whilst suckling in BN positions, pressure radiates from navel to limbs triggering neonatal reflexes facilitating latch and sustaining milk transfer. During BN, mothers and babies are often lightly dressed challenging the current emphasis on skin-to-skin as the only early intervention aiding breastfeeding initiation. Importantly, BN research suggests that ventral pressure is the neonatal behavioral releaser for both interventions, not dress state. Attend this presentation to clarify continuity theory and discover some unexpected breastfeeding “myths”.

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13-02-2018 14:00 13-02-2018 15:00 35 Biological Nurturing--- applying the continuum concept to breastfeeding Biological nurturing (BN), a mother-led approach, promotes body contact even when the baby is asleep. BN theories link hormonal continuity from pregnancy to postpartum and reflex continuity from womb to world. During the last weeks of pregnancy, oxytocin levels rise, peaking immediately following birth. Early baby gazing and eye-to-eye contact help maintain this high oxytocin pulsatility associated with increased breastfeeding duration. Experts in Body-Mind Centering suggest that fetal reflexes radiate from the navel--- the core, thus preparing neonatal movement. Whilst suckling in BN positions, pressure radiates from navel to limbs triggering neonatal reflexes facilitating latch and sustaining milk transfer. During BN, mothers and babies are often lightly dressed challenging the current emphasis on skin-to-skin as the only early intervention aiding breastfeeding initiation. Importantly, BN research suggests that ventral pressure is the neonatal behavioral releaser for both interventions, not dress state. Attend this presentation to clarify continuity theory and discover some unexpected breastfeeding “myths”. www.GOLDMidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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In this session Carol Gray will make a compelling argument for an idea that is not mainstream – even among radical homebirth midwives. As a midwife she has long recognized that the baby who couldn't descend into mom's pelvis and get born presents a problem. Carol has since recognized that the baby who drops deeply into mom's pelvis and stays there long (days, weeks or months) before the onset of labor presents an even bigger problem. Babies know how to position themselves for birth. They ought to be able to bob in and out of mom's pelvis until labor begins. When they drop down and stay down it's because they are stuck. In this session Carol will show the anatomy and the biomechanics of this problem. She will describe the aftermath: things like torticollis, plagiocephaly, breastfeeding difficulties, scoliosis, cesarean birth, inductions, etc. Carol will also give some resources for how we can help.

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20-02-2018 23:00 21-02-2018 00:00 35 Breaking Off Our Engagement With Engagement In this session Carol Gray will make a compelling argument for an idea that is not mainstream – even among radical homebirth midwives. As a midwife she has long recognized that the baby who couldn't descend into mom's pelvis and get born presents a problem. Carol has since recognized that the baby who drops deeply into mom's pelvis and stays there long (days, weeks or months) before the onset of labor presents an even bigger problem. Babies know how to position themselves for birth. They ought to be able to bob in and out of mom's pelvis until labor begins. When they drop down and stay down it's because they are stuck. In this session Carol will show the anatomy and the biomechanics of this problem. She will describe the aftermath: things like torticollis, plagiocephaly, breastfeeding difficulties, scoliosis, cesarean birth, inductions, etc. Carol will also give some resources for how we can help. www.GOLDmidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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Bullying affects staff, patients and families. This presentation will address bullying within the Midwifery field, what it is and why it is a problem. We will discuss how bullying is related to culture, and why attempts to change culture often fail. Work to try to shape a new response to bullying must include an awareness of culture, but more importantly, efforts to reduce bullying should follow a Person Centered Approached (PCA). We will discuss what PAC approaches look like, their dynamics and potency.

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13-02-2018 16:00 13-02-2018 17:00 35 Bullying and Humanity - Listening Spaces to Support Midwives Bullying affects staff, patients and families. This presentation will address bullying within the Midwifery field, what it is and why it is a problem. We will discuss how bullying is related to culture, and why attempts to change culture often fail. Work to try to shape a new response to bullying must include an awareness of culture, but more importantly, efforts to reduce bullying should follow a Person Centered Approached (PCA). We will discuss what PAC approaches look like, their dynamics and potency. www.GOLDmidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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Traditionally, health care services target mothers – and engaging fathers has generally been overlooked. As a result fathers feel excluded and unsupported.
However, there has been growing recognition of the importance of parenting partnerships and fathers’ contribution to children’s development. As a result services are becoming more conscious of this. In a recent survey midwives agreed that including fathers is a part of their role but generally did not feel educated or well prepared to do this.
Individual providers and maternity care services must review the care they provide to assess their policies and resources, for example, and how they promote father and family inclusive care.

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20-02-2018 21:00 20-02-2018 22:00 35 Engaged and In Gear: Fathers in Maternal and Newborn Health Traditionally, health care services target mothers – and engaging fathers has generally been overlooked. As a result fathers feel excluded and unsupported. However, there has been growing recognition of the importance of parenting partnerships and fathers’ contribution to children’s development. As a result services are becoming more conscious of this. In a recent survey midwives agreed that including fathers is a part of their role but generally did not feel educated or well prepared to do this. Individual providers and maternity care services must review the care they provide to assess their policies and resources, for example, and how they promote father and family inclusive care. www.GOLDmidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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Electronic fetal monitoring (EFM) was introduced into widespread clinical practice in the 1970-80s on the premise that it would help detect abnormal fetal heart rate patterns thought to be associated with fetal hypoxia, and thereby allow earlier intervention to prevent fetal neurological damage or death. Despite the recognised limitations of EFM, it’s use has become ubiquitous particularly in high-income countries. In this presentation, Declan will be address the evidence underpinning the use of EFM and in particular the use of cardiotocography. His presentation will focus largely on findings from Cochrane systematic reviews related to aspects of fetal monitoring including how to read and interpret forest plots, which are a common means of presenting the findings of meta analyses of the effects of interventions on outcomes. Within his talk, Declan will highlight examples of discordance between evidence, practice and practice guidelines.

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12-02-2018 17:00 12-02-2018 18:00 35 Fetal monitoring, Evidence and challenges Electronic fetal monitoring (EFM) was introduced into widespread clinical practice in the 1970-80s on the premise that it would help detect abnormal fetal heart rate patterns thought to be associated with fetal hypoxia, and thereby allow earlier intervention to prevent fetal neurological damage or death. Despite the recognised limitations of EFM, it’s use has become ubiquitous particularly in high-income countries. In this presentation, Declan will be address the evidence underpinning the use of EFM and in particular the use of cardiotocography. His presentation will focus largely on findings from Cochrane systematic reviews related to aspects of fetal monitoring including how to read and interpret forest plots, which are a common means of presenting the findings of meta analyses of the effects of interventions on outcomes. Within his talk, Declan will highlight examples of discordance between evidence, practice and practice guidelines. www.GOLDmidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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In this presentation the current state of normal birth around the world will be described and the backlash and politics around the issue explored. The long and short term benefits will be reported along with new emerging research on the issue. Key strategies for optimizing normal birth both in a practical and political sense will be discussed.

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05-02-2018 19:00 05-02-2018 20:15 35 Fighting for normal birth in an alternative facts, post truth world In this presentation the current state of normal birth around the world will be described and the backlash and politics around the issue explored. The long and short term benefits will be reported along with new emerging research on the issue. Key strategies for optimizing normal birth both in a practical and political sense will be discussed. www.GOLDmidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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Knowledge of pelvic floor health is important for the optimal care of women during pregnancy, birth and in the postpartum period, and for nurses’ and midwives’ self-care. This presentation will outline what pelvic floor health is, the major risk factors for dysfunction and evidence-based recommendations for the prevention and management of symptoms.

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21-02-2018 01:00 21-02-2018 02:00 35 Pelvic floor health: pregnancy, birth and beyond Knowledge of pelvic floor health is important for the optimal care of women during pregnancy, birth and in the postpartum period, and for nurses’ and midwives’ self-care. This presentation will outline what pelvic floor health is, the major risk factors for dysfunction and evidence-based recommendations for the prevention and management of symptoms. www.GOLDmidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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The placenta is the only disposable vital organ. For all but the very beginning of gestation, the placenta is essential to the baby’s survival. Abnormalities and dysfunction of this organ and its associated structures such as the cord and membranes can have dire consequences to mother and/or baby. Placentas Behaving Badly is a lively look at some of the placental pathology that matters to a midwife. We will discuss abnormal cord insertions, alloimmunization, abruption, vasa previa, and placental infarction. Because the placenta is a diary of intrauterine life, we will discuss how to examine a placenta after birth, and consider how unusual findings relate to the health of the infant.

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13-02-2018 20:00 13-02-2018 21:00 35 Placentas Behaving Badly The placenta is the only disposable vital organ. For all but the very beginning of gestation, the placenta is essential to the baby’s survival. Abnormalities and dysfunction of this organ and its associated structures such as the cord and membranes can have dire consequences to mother and/or baby. Placentas Behaving Badly is a lively look at some of the placental pathology that matters to a midwife. We will discuss abnormal cord insertions, alloimmunization, abruption, vasa previa, and placental infarction. Because the placenta is a diary of intrauterine life, we will discuss how to examine a placenta after birth, and consider how unusual findings relate to the health of the infant. www.GOLDmidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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Traditionally, obstetrics has failed to regard the unborn child (prenate) as a conscious being with the ability to feel or be influenced by its perinatal experiences. The field of pre and perinatal psychology dates back to 1981 with Dr. Otto Frank, an assistant to Dr. Sigmund Freud published his book on the trauma of birth” Since that time, the sciences of embryology, hypnosis, neurobiology and epigenetics have provided evidence to show that from as early as conception, the prenate is influenced psychologically and physiologically by events which occur in the womb. Through implicit or cellular memory, a newborn traumatized during the perinatal period, may develop dysfunctional behavioral patterns to cope with unresolved emotional triggers.. The earlier in life the unresolved issues were first experienced, and the response, can prompt epigenetic changes beginning as early as in utero. These intrauterine epigenetic changes can manifest as mental and/or physical disease in adulthood. By understanding theories of pre and perinatal psychology, clinicians can introduce practices and protocols to help their clients avoid, resolve or mitigate the impact of perinatal trauma.

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12-02-2018 15:00 12-02-2018 16:00 35 Pre and Perinatal Psychology to Improve Birth Outcomes Traditionally, obstetrics has failed to regard the unborn child (prenate) as a conscious being with the ability to feel or be influenced by its perinatal experiences. The field of pre and perinatal psychology dates back to 1981 with Dr. Otto Frank, an assistant to Dr. Sigmund Freud published his book on the trauma of birth” Since that time, the sciences of embryology, hypnosis, neurobiology and epigenetics have provided evidence to show that from as early as conception, the prenate is influenced psychologically and physiologically by events which occur in the womb. Through implicit or cellular memory, a newborn traumatized during the perinatal period, may develop dysfunctional behavioral patterns to cope with unresolved emotional triggers.. The earlier in life the unresolved issues were first experienced, and the response, can prompt epigenetic changes beginning as early as in utero. These intrauterine epigenetic changes can manifest as mental and/or physical disease in adulthood. By understanding theories of pre and perinatal psychology, clinicians can introduce practices and protocols to help their clients avoid, resolve or mitigate the impact of perinatal trauma. www.GOLDmidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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Increasingly, Birth in the USA is taking place in operating rooms. Cesarean sections are commonplace and accepted as "the best route of entry" in far too many settings. What's wrong with having a cesarean? Plenty. What's so important about avoiding the first one and helping those women who have had them to have subsequent vaginal/natural birt as their babies arrive into the world? What are the ramifications of a culture where babies are surgically delivered? How do we educated and enlighten pregnant women/couples and help them to overcome the fear, take better of themselves, find experienced, caring and naturally-oriented care providers and have a birth that lifts them and helps them to begin mother/parenthood with an intact body in a place of confidence and joy rather than having to recover from a slash on their abdomen and on their uterus?

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13-02-2018 18:00 13-02-2018 19:00 35 Preventing Primary and Repeat Cesareans Increasingly, Birth in the USA is taking place in operating rooms. Cesarean sections are commonplace and accepted as "the best route of entry" in far too many settings. What's wrong with having a cesarean? Plenty. What's so important about avoiding the first one and helping those women who have had them to have subsequent vaginal/natural birt as their babies arrive into the world? What are the ramifications of a culture where babies are surgically delivered? How do we educated and enlighten pregnant women/couples and help them to overcome the fear, take better of themselves, find experienced, caring and naturally-oriented care providers and have a birth that lifts them and helps them to begin mother/parenthood with an intact body in a place of confidence and joy rather than having to recover from a slash on their abdomen and on their uterus? www.GOLDmidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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All of us serving new and growing families, share a sixth sense of intense listening. In each client-provider conversation we are assessing every word, internal wheels turning all the while. Not that we go looking for problems, rather that we hope to identify and move to resolve them before they become life threatening. This presentation will hone our skills and offer professional tools for how best to obtain and process information, accurately assess developing problems and effectively seek consultation, collaboration or transfer of care.

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12-02-2018 21:00 12-02-2018 22:00 35 Promoting Safe Transfers from planned Out of Hospital Births All of us serving new and growing families, share a sixth sense of intense listening. In each client-provider conversation we are assessing every word, internal wheels turning all the while. Not that we go looking for problems, rather that we hope to identify and move to resolve them before they become life threatening. This presentation will hone our skills and offer professional tools for how best to obtain and process information, accurately assess developing problems and effectively seek consultation, collaboration or transfer of care. www.GOLDmidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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This workshop will provide an evidence-based framework for engaging with LGBTQ2S clients in midwifery care. Learn what constitutes a truly welcoming space for this unique and often marginalized client population. Review considerations for providing sensitive and specialized care, including issues unique to lesbian families and transgender parents. Understand what you can do to bridge gaps in midwifery care for LGBTQ2S people becoming parents via pregnancy.

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20-02-2018 19:00 20-02-2018 20:00 35 Providing preconception and prenatal care for LGBTQ2S families This workshop will provide an evidence-based framework for engaging with LGBTQ2S clients in midwifery care. Learn what constitutes a truly welcoming space for this unique and often marginalized client population. Review considerations for providing sensitive and specialized care, including issues unique to lesbian families and transgender parents. Understand what you can do to bridge gaps in midwifery care for LGBTQ2S people becoming parents via pregnancy. www.GOLDmidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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While most midwives are diligent about maintaining pelvic floor integrity during birth, genital tract trauma occurs in up to 70% of women during vaginal birth. Birthing women expect midwives to be skilled and confident in their ability to perform perineal repair. This complex skill set requires multiple learning opportunities to develop both competence and the ability to suture with confidence. Perineal repair skills require manual dexterity and the ability to visually identify and approximate anatomic structures. The ability to perform an effective wound closure requires midwives actively master the skills required for systematic wound evaluation and anatomic re-­‐approximation of tissues. Supportive mentoring and intentional self-­‐directed practice are critical to the learning process. This session focuses on the equipment, supplies, and technical skills used during suturing of the pelvic floor after birth, and recommendations for simulation and practice.

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12-02-2018 19:00 12-02-2018 20:00 35 Suturing Skills for Midwifery Practice While most midwives are diligent about maintaining pelvic floor integrity during birth, genital tract trauma occurs in up to 70% of women during vaginal birth. Birthing women expect midwives to be skilled and confident in their ability to perform perineal repair. This complex skill set requires multiple learning opportunities to develop both competence and the ability to suture with confidence. Perineal repair skills require manual dexterity and the ability to visually identify and approximate anatomic structures. The ability to perform an effective wound closure requires midwives actively master the skills required for systematic wound evaluation and anatomic re-­‐approximation of tissues. Supportive mentoring and intentional self-­‐directed practice are critical to the learning process. This session focuses on the equipment, supplies, and technical skills used during suturing of the pelvic floor after birth, and recommendations for simulation and practice. www.GOLDmidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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Despite some advances in individual technologies and strategies, hemorrhage remains one of the major killers of pregnant, childbearing, and postpartum women, especially in lower resourced settings. Maternal mortalities and morbidities have actually risen in many of these places, including in some higher resourced settings, such as the US. In this presentation we will review some of the newer innovations in hemorrhage prevention, recognition, and management, such as the improvised, low cost uterine balloon tamponade, non-pneumatic anti-shock garment, use of standardized blood mats, community distribution of oral/sublingual misoprostol, a uterine balloon that releases Tranexamic Acid, drones for blood delivery in remote areas, and more. We will discuss the influence on Ministries of Health and program managers of the World Health Organization’s recommendations on technologies for PPH. We will then describe and discuss why PPH bundles may be a more efficient way to package and train on technologies and strategies.

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12-02-2018 23:00 13-02-2018 00:00 35 Updates in Obstetric Hemorrhage Prevention, Recognition, and Management: Individual devices, Bundles, and Clinical Pathways for Saving Lives in Low Resource settings Despite some advances in individual technologies and strategies, hemorrhage remains one of the major killers of pregnant, childbearing, and postpartum women, especially in lower resourced settings. Maternal mortalities and morbidities have actually risen in many of these places, including in some higher resourced settings, such as the US. In this presentation we will review some of the newer innovations in hemorrhage prevention, recognition, and management, such as the improvised, low cost uterine balloon tamponade, non-pneumatic anti-shock garment, use of standardized blood mats, community distribution of oral/sublingual misoprostol, a uterine balloon that releases Tranexamic Acid, drones for blood delivery in remote areas, and more. We will discuss the influence on Ministries of Health and program managers of the World Health Organization’s recommendations on technologies for PPH. We will then describe and discuss why PPH bundles may be a more efficient way to package and train on technologies and strategies. www.GOLDMidwifery.com GOLD Perinatal Online Conference false DD/MM/YYYY

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