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The current culture of maternity care in the United States is at best lacking and at worst dangerous. With maternal mortality and postpartum depression rates at an all time, unnecessary inductions and cesareans still incredibly common and breastfeeding rates staggeringly low, it’s time for a change. Midwifery care has been proven to improve almost all of those statistics but as it stands, there are not enough midwives to impact this kind of drastic change we need. The reason we don’t have enough midwives is because the rates of burnout in midwifery are so high. It’s time for midwives to join forces and begin taking care of themselves and each other to avoid burnout so that we can help more women have positive and empowering birth experiences and change the current culture of maternity care. This presentation will discuss why it’s so important to avoid burnout and give practical suggestions on how to avoid burnout both in midwifery education and midwifery practice.

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03-02-2020 08:00 03-02-2020 09:00 35 Avoiding Burnout in Midwifery The current culture of maternity care in the United States is at best lacking and at worst dangerous. With maternal mortality and postpartum depression rates at an all time, unnecessary inductions and cesareans still incredibly common and breastfeeding rates staggeringly low, it’s time for a change. Midwifery care has been proven to improve almost all of those statistics but as it stands, there are not enough midwives to impact this kind of drastic change we need. The reason we don’t have enough midwives is because the rates of burnout in midwifery are so high. It’s time for midwives to join forces and begin taking care of themselves and each other to avoid burnout so that we can help more women have positive and empowering birth experiences and change the current culture of maternity care. This presentation will discuss why it’s so important to avoid burnout and give practical suggestions on how to avoid burnout both in midwifery education and midwifery practice. GOLD Perinatal Online Conference false DD/MM/YYYY

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When a woman enjoys a physiological birth (spontaneous onset of labour without medical interventions) she experiences a deep sense of accomplishment, fulfillment and empowerment. Pregnant women if given the right evidence based information on the normal physiology of labour and birth; enlightened on the options of comfort measures to help cope with the pain of labour will feel more confident to a birth without unnecessary interventions.

The ACOG Committee Opinion No. 76, February 2017, suggested evidence based strategies for low-risk pregnant women. Delaying admission until active phase (> 6cm cervical dilatation), monitoring the fetal heart intermittent auscultation with a hand-held Doppler for monitoring the fetal heart; remaining mobile and upright; ensuring adequate intake of oral liquids and /or food, the presence of a supportive birth companion, the avoidance of unnecessary IV oxytocin infusion, leaving the bag of membranes to break spontaneously, to birth in the position of choice, to hold the baby skin to skin and initiate early breastfeeding are effective steps towards a natural birth. All of this can be offered by a professional midwife trained to meet global standards of competence as outlined by WHO/ICM.

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24-02-2020 16:00 24-02-2020 17:15 35 Birth Without Interventions When a woman enjoys a physiological birth (spontaneous onset of labour without medical interventions) she experiences a deep sense of accomplishment, fulfillment and empowerment. Pregnant women if given the right evidence based information on the normal physiology of labour and birth; enlightened on the options of comfort measures to help cope with the pain of labour will feel more confident to a birth without unnecessary interventions. The ACOG Committee Opinion No. 76, February 2017, suggested evidence based strategies for low-risk pregnant women. Delaying admission until active phase (> 6cm cervical dilatation), monitoring the fetal heart intermittent auscultation with a hand-held Doppler for monitoring the fetal heart; remaining mobile and upright; ensuring adequate intake of oral liquids and /or food, the presence of a supportive birth companion, the avoidance of unnecessary IV oxytocin infusion, leaving the bag of membranes to break spontaneously, to birth in the position of choice, to hold the baby skin to skin and initiate early breastfeeding are effective steps towards a natural birth. All of this can be offered by a professional midwife trained to meet global standards of competence as outlined by WHO/ICM. GOLD Perinatal Online Conference false DD/MM/YYYY

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We will view birth through the lens of a physiological and transformative event that is satisfying and empowering rather than a painful ordeal that must be endured. More and more women are aware of the transformative potential of their births and are showing up. They are now looking for caregivers...doulas, doctors, midwives, nurses...who can accompany them, witness them and not interfere. They are seeking deeply connected conscious caregivers.

We will focus on 4 salient points:
1. Women do not give birth in 'ordinary consciousness' but rather in a deeper and authentic state of consciousness that expands their perspective.
2. What is that deeper state of consciousness, how can we language it, how can we get there and be in tandem with women rather then need to manage them?
3. All women have instinctual responses to their births, whether they access them or not. They much appreciate being validated, trusted and not disturbed in acting on their instinctual responses.
4. How can we as caregivers trust birth, trust women and trust ourselves to validate a woman's instincts and nurture and facilitate her to unfold these responses?

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03-02-2020 17:00 03-02-2020 18:15 35 Conscious Caregiving Transforms the World We will view birth through the lens of a physiological and transformative event that is satisfying and empowering rather than a painful ordeal that must be endured. More and more women are aware of the transformative potential of their births and are showing up. They are now looking for caregivers...doulas, doctors, midwives, nurses...who can accompany them, witness them and not interfere. They are seeking deeply connected conscious caregivers. We will focus on 4 salient points: 1. Women do not give birth in 'ordinary consciousness' but rather in a deeper and authentic state of consciousness that expands their perspective. 2. What is that deeper state of consciousness, how can we language it, how can we get there and be in tandem with women rather then need to manage them? 3. All women have instinctual responses to their births, whether they access them or not. They much appreciate being validated, trusted and not disturbed in acting on their instinctual responses. 4. How can we as caregivers trust birth, trust women and trust ourselves to validate a woman's instincts and nurture and facilitate her to unfold these responses? GOLD Perinatal Online Conference false DD/MM/YYYY

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Join Dr Riobe in taking a critical look at childhood diseases and the real reasons they're on the rise. Autism was astoundingly rare just 30 years ago with a rate of 1 in 10,000 children diagnosed. It is now unfathomably afflicting 1 out of every 65 children born today. We're told it's genetics. We're told it's because we've refined our diagnostic capabilities. Really??? Explore the cutting-edge research that corroborates ancient traditional teachings to learn the real causes of childhood diseases like cancer and autism in order to shift the paradigm from early diagnosis and reaction to diseases to one that empowers future mothers to prevent childhood diseases like cancer and autism. Learn how you can make a difference in a mother's life as well as her unborn child even before she gets pregnant.

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03-02-2020 08:00 03-02-2020 09:00 35 Could an Innovative Approach to Preconception Care Be the Key to Preventing Autism? Join Dr Riobe in taking a critical look at childhood diseases and the real reasons they're on the rise. Autism was astoundingly rare just 30 years ago with a rate of 1 in 10,000 children diagnosed. It is now unfathomably afflicting 1 out of every 65 children born today. We're told it's genetics. We're told it's because we've refined our diagnostic capabilities. Really??? Explore the cutting-edge research that corroborates ancient traditional teachings to learn the real causes of childhood diseases like cancer and autism in order to shift the paradigm from early diagnosis and reaction to diseases to one that empowers future mothers to prevent childhood diseases like cancer and autism. Learn how you can make a difference in a mother's life as well as her unborn child even before she gets pregnant. GOLD Perinatal Online Conference false DD/MM/YYYY

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Since 2013 Aarhus University Hospital has offered all women a postnatal check-up 2-3 days after birth. We provide services for approx. 4.000 vaginal births annually.

More than 90% of primiparous women sustain perineal injury or lacerations to the labial area that requires surgical repair following vaginal birth.

I will present cases and photos showing examples of normal, delayed and pathological healing of different types of perineal lacerations. 1) Healing of 1st and 2nd degree perineal tears
2) Mediolateral episiotomies
3) Healing of 3rd and 4th degree tears (anal sphincter injuries)

Inadequate primary perineal repair or early suture break down was found in approx. 1% of the population. We wish to share experiences from a case study of 250+ cases including 1st -2nd degree lacerations and mediolateral episiotomies.

Our findings with more than 40 photo documented cases featuring different healing outcomes are available as an online resource through the website GynZone.net.

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03-02-2020 08:00 03-02-2020 09:00 35 Healing Well After Childbirth: Experiences from a Midwifery-Led Pelvic Floor Clinic in Denmark Since 2013 Aarhus University Hospital has offered all women a postnatal check-up 2-3 days after birth. We provide services for approx. 4.000 vaginal births annually. More than 90% of primiparous women sustain perineal injury or lacerations to the labial area that requires surgical repair following vaginal birth. I will present cases and photos showing examples of normal, delayed and pathological healing of different types of perineal lacerations. 1) Healing of 1st and 2nd degree perineal tears 2) Mediolateral episiotomies 3) Healing of 3rd and 4th degree tears (anal sphincter injuries) Inadequate primary perineal repair or early suture break down was found in approx. 1% of the population. We wish to share experiences from a case study of 250+ cases including 1st -2nd degree lacerations and mediolateral episiotomies. Our findings with more than 40 photo documented cases featuring different healing outcomes are available as an online resource through the website GynZone.net. GOLD Perinatal Online Conference false DD/MM/YYYY

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Hyperemesis gravidarum (HG) is described as severe nausea and vomiting during pregnancy, which often results in dehydration, nutritional deficiencies, metabolic imbalances, and debility. Early diagnosis and treatment are crucial to prevent serious morbidity and mortality, and to promote healthy outcomes for both the mother and baby. Obstetrical clinicians can reduce maternal suffering and prevent serious complications through early and accurate assessment followed by effective therapeutic interventions. This session will discuss best practices in the assessment and management of HG patients.

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03-02-2020 08:00 03-02-2020 09:00 35 Hyperemesis Gravidarum: Preventing Morbidity and Mortality Hyperemesis gravidarum (HG) is described as severe nausea and vomiting during pregnancy, which often results in dehydration, nutritional deficiencies, metabolic imbalances, and debility. Early diagnosis and treatment are crucial to prevent serious morbidity and mortality, and to promote healthy outcomes for both the mother and baby. Obstetrical clinicians can reduce maternal suffering and prevent serious complications through early and accurate assessment followed by effective therapeutic interventions. This session will discuss best practices in the assessment and management of HG patients. GOLD Perinatal Online Conference false DD/MM/YYYY

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Midwives are well situated to provide inclusive care to our trans and non-binary clients and families. Our grounding in client-centred care, informed choice and choice of birth place are an asset when caring for pregnant people and their families who may have experienced discrimination in the health care system and in society in general. Expertise in trauma informed care can be utilized and broadened to a focus on trans informed care to facilitate safe, respectful and celebratory pregnancy, birth and postpartum care. This talk will explore how to build inclusive practices and philosophies of care. This will allow for a deeper conversation around safety for our clients as well as for midwives and other health care providers.

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03-02-2020 08:00 03-02-2020 09:00 35 Inclusive Midwifery Care: Providing safe, respectful and celebratory care to our trans and non-binary families Midwives are well situated to provide inclusive care to our trans and non-binary clients and families. Our grounding in client-centred care, informed choice and choice of birth place are an asset when caring for pregnant people and their families who may have experienced discrimination in the health care system and in society in general. Expertise in trauma informed care can be utilized and broadened to a focus on trans informed care to facilitate safe, respectful and celebratory pregnancy, birth and postpartum care. This talk will explore how to build inclusive practices and philosophies of care. This will allow for a deeper conversation around safety for our clients as well as for midwives and other health care providers. GOLD Perinatal Online Conference false DD/MM/YYYY

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Birth clips, called kurenme in Japan, are small, simple metal clips used for treating perineal trauma. In Japan, midwives are not allowed to suture, except for in emergencies, thus Japanese midwives in birth centers have used birth clips to treat perineal tears alternative to suturing for many years. In this lecture, we will overview and learn how to use birth clip in clinical situation. Also, sharing practice to prevent lacerations by gentle hands on techniques of delivery. The policy of ‘wait’, ‘support natural process’ and ‘speed’ may be the key for perineal care. Occasionally midwives intervene; however, internal exam should be minimal to prevent perineum edema and to get along with and wait calmly.

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03-02-2020 08:00 03-02-2020 09:00 35 Kurenme Birth Clips: A Japanese Midwifery Alternative to Suturing Birth clips, called kurenme in Japan, are small, simple metal clips used for treating perineal trauma. In Japan, midwives are not allowed to suture, except for in emergencies, thus Japanese midwives in birth centers have used birth clips to treat perineal tears alternative to suturing for many years. In this lecture, we will overview and learn how to use birth clip in clinical situation. Also, sharing practice to prevent lacerations by gentle hands on techniques of delivery. The policy of ‘wait’, ‘support natural process’ and ‘speed’ may be the key for perineal care. Occasionally midwives intervene; however, internal exam should be minimal to prevent perineum edema and to get along with and wait calmly. GOLD Perinatal Online Conference false DD/MM/YYYY

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Mediation is a peaceful way to resolve and prevent conflict. By drawing attention to options strategies and reframing the real issues parties can release stuckness to find positive ways of communicating. We can mediate for each other and ourselves through awareness & self care.

Family conflict affects us all. Midwives have their own families at home and their familiar relationships at work. The families we care for may have their own conflicts. Mediation will bring mindfulness to being with ourselves with increased sense of calm. Midwives are often being all things to others and not finding time to be with themselves. Connecting to Mindfulness can bring mediation into our relationships and improved communications.

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03-02-2020 08:00 03-02-2020 09:00 35 Mediation Mediation is a peaceful way to resolve and prevent conflict. By drawing attention to options strategies and reframing the real issues parties can release stuckness to find positive ways of communicating. We can mediate for each other and ourselves through awareness & self care. Family conflict affects us all. Midwives have their own families at home and their familiar relationships at work. The families we care for may have their own conflicts. Mediation will bring mindfulness to being with ourselves with increased sense of calm. Midwives are often being all things to others and not finding time to be with themselves. Connecting to Mindfulness can bring mediation into our relationships and improved communications. GOLD Perinatal Online Conference false DD/MM/YYYY

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Despite a steady drop globally in maternal and newborn deaths since 1990, thousands of women and newborns still die each year during pregnancy and childbirth. South Africa, together with other countries, failed to achieve the Millennium Development Goal of reducing maternal mortality by three quarters by 2015. This is despite the positive efforts made in the country towards achieving these goals. However, much more still needs to be done. For that reason, proper and safe care of labouring women remains the identified major focus to prevent these deaths.

The study was the culmination of an investigation into the problem of poor performance regarding maternal and perinatal outcomes as identified by the researcher. The aim of the study was to understand the experiences and perceptions of the women and the midwives regarding the clinical practices in public maternity units in South Africa in order to facilitate the scaling-up of the midwifery practice.

The study found that midwives were committed to provide quality care but major factors needed to be addressed to facilitate scaling-up of clinical midwifery practices. The midwifery profession needed to be strengthened and an enabling working environment provided. Based on the results of the study as well as the theoretical, conceptual and contextual framework, two strategies were developed:
Strategy 1: Empowering midwives to deliver woman-centred care in public sector maternity units
Strategy 2: Creating an enabling work environment in order to deliver woman-centred care in public sector maternity units

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03-02-2020 08:00 03-02-2020 09:00 35 Perspectives of South African Women and Midwives on Clinical Practice in Public Maternity Units: Facilitating the Scaling-Up of Such Clinical Practices Despite a steady drop globally in maternal and newborn deaths since 1990, thousands of women and newborns still die each year during pregnancy and childbirth. South Africa, together with other countries, failed to achieve the Millennium Development Goal of reducing maternal mortality by three quarters by 2015. This is despite the positive efforts made in the country towards achieving these goals. However, much more still needs to be done. For that reason, proper and safe care of labouring women remains the identified major focus to prevent these deaths. The study was the culmination of an investigation into the problem of poor performance regarding maternal and perinatal outcomes as identified by the researcher. The aim of the study was to understand the experiences and perceptions of the women and the midwives regarding the clinical practices in public maternity units in South Africa in order to facilitate the scaling-up of the midwifery practice. The study found that midwives were committed to provide quality care but major factors needed to be addressed to facilitate scaling-up of clinical midwifery practices. The midwifery profession needed to be strengthened and an enabling working environment provided. Based on the results of the study as well as the theoretical, conceptual and contextual framework, two strategies were developed: Strategy 1: Empowering midwives to deliver woman-centred care in public sector maternity units Strategy 2: Creating an enabling work environment in order to deliver woman-centred care in public sector maternity units GOLD Perinatal Online Conference false DD/MM/YYYY

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Expecting parents, particularly those anticipating first-time parenthood, are most ready to learn about pregnancy, labor and birth. Much focus and attention for expecting families center on these periods of uncertainty and often fear. Our natural tendency is to understand and gain knowledge of what impacts us most at times we experience an event. Consequently, for new parents, emphasis is placed on preparing for childbirth with little education or time dedicated to preparedness for parenting. Most families in the US experience birth in-hospital with discharge (following normal vaginal birth) by 48 hours. Speaking with numerous families, anecdotal evidence shows the typical US family experience less than three hours of education on care for self and newborn prior to being home with their baby. The initial weeks of parenthood are a time of universal vulnerability. And also bring one of the most challenging periods of transition from a confident adult to an inexperienced, first-time parent. Many parents express feeling lied to and being set up for the wildest shock of their life- being someone’s parent. Identifying gaps in preparedness in parenting will assist midwives, nurses and doulas in providing families with real information in real time.

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03-02-2020 08:00 03-02-2020 09:00 35 Postpartum Pause: Identifying Gaps In Preparedness for Parenting Expecting parents, particularly those anticipating first-time parenthood, are most ready to learn about pregnancy, labor and birth. Much focus and attention for expecting families center on these periods of uncertainty and often fear. Our natural tendency is to understand and gain knowledge of what impacts us most at times we experience an event. Consequently, for new parents, emphasis is placed on preparing for childbirth with little education or time dedicated to preparedness for parenting. Most families in the US experience birth in-hospital with discharge (following normal vaginal birth) by 48 hours. Speaking with numerous families, anecdotal evidence shows the typical US family experience less than three hours of education on care for self and newborn prior to being home with their baby. The initial weeks of parenthood are a time of universal vulnerability. And also bring one of the most challenging periods of transition from a confident adult to an inexperienced, first-time parent. Many parents express feeling lied to and being set up for the wildest shock of their life- being someone’s parent. Identifying gaps in preparedness in parenting will assist midwives, nurses and doulas in providing families with real information in real time. GOLD Perinatal Online Conference false DD/MM/YYYY

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Postpartum thyroiditis affects 5 - 10% of women in the USA and 1 in 12 women worldwide. Possessing a quite variable presentation, it can manifest as hyper- or hypothyroidism alone, or as a period of hyperthyroid followed by hypothyroid. Treatment is complicated by the breastfeeding dyad. Prescription medications as well as complementary and alternative therapies may be considered.

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03-02-2020 08:00 03-02-2020 09:00 35 Postpartum Thyroiditis Postpartum thyroiditis affects 5 - 10% of women in the USA and 1 in 12 women worldwide. Possessing a quite variable presentation, it can manifest as hyper- or hypothyroidism alone, or as a period of hyperthyroid followed by hypothyroid. Treatment is complicated by the breastfeeding dyad. Prescription medications as well as complementary and alternative therapies may be considered. GOLD Perinatal Online Conference false DD/MM/YYYY

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Drug and alcohol use during pregnancy continues to be a substantial global health and social concern. In this workshop, we will reflect on the history of how society and health care providers have viewed and treated women who use substances during pregnancy. Using the perspectives of trauma informed care, harm reduction and health equity, we will explore recent developments in perinatal and neonatal evidence-informed practice in the care of women and infants. Exemplars of innovative community and hospital programs will be shared.

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03-02-2020 08:00 03-02-2020 09:00 35 Substance Use During Pregnancy: Supporting Healthy Outcomes for Women, Infants and Their Families Drug and alcohol use during pregnancy continues to be a substantial global health and social concern. In this workshop, we will reflect on the history of how society and health care providers have viewed and treated women who use substances during pregnancy. Using the perspectives of trauma informed care, harm reduction and health equity, we will explore recent developments in perinatal and neonatal evidence-informed practice in the care of women and infants. Exemplars of innovative community and hospital programs will be shared. GOLD Perinatal Online Conference false DD/MM/YYYY

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The results of the MBRRACE report 2018, a UK study into maternal deaths made me want to look beyond the statistics and see what, if anything, could be done to close the disparities gap. Much of my knowledge has been gained via personal stories, blog posts, articles, news reports and reading research about black maternal deaths, as well as from the MBRRACE study itself.

Looking into the statistics caused me to want to know if they were specific to the UK and the West and if so, why? By discovering that the outcomes for black women were better on the African continent, I began to read about the differences in lifestyles to see if that made a difference. Acknowledging systemic and structural racism brought many issues to light. From this I was able to hypothesise that implicit and explicit bias are significant factors in the poor outcomes. The inevitable conclusion to this, in my mind, was the need for people to be supported by those who would work without, or with a minimum level of bias ergo black women being supported by black women.

There needs to be a more holistic approach to the care of black women, so that non black birthkeepers are also able to give good, safe support.

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03-02-2020 08:00 03-02-2020 09:00 35 The Importance of Black Birthkeepers The results of the MBRRACE report 2018, a UK study into maternal deaths made me want to look beyond the statistics and see what, if anything, could be done to close the disparities gap. Much of my knowledge has been gained via personal stories, blog posts, articles, news reports and reading research about black maternal deaths, as well as from the MBRRACE study itself. Looking into the statistics caused me to want to know if they were specific to the UK and the West and if so, why? By discovering that the outcomes for black women were better on the African continent, I began to read about the differences in lifestyles to see if that made a difference. Acknowledging systemic and structural racism brought many issues to light. From this I was able to hypothesise that implicit and explicit bias are significant factors in the poor outcomes. The inevitable conclusion to this, in my mind, was the need for people to be supported by those who would work without, or with a minimum level of bias ergo black women being supported by black women. There needs to be a more holistic approach to the care of black women, so that non black birthkeepers are also able to give good, safe support. GOLD Perinatal Online Conference false DD/MM/YYYY

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