Midwifery Today Conference
Suva, Fiji • 20–24 June 2016
“Celebrating Love from the Beginning”
Monday • 20 June 2016 • Pre-Conference
Fiji National Anthem
Roll Call Of Nations of the World in Attendance
Chief Guest Address: Voreqe Bainimarama, Prime Minister of Fiji
Response: President International Midwifery Today, Jan Tritten
Official Photograph and Morning Tea
Learn how to evaluate and nurture the emotional, spiritual, physical and psychological well-being of pregnant and birthing women. Learn about nutrition and the heart of care during the prenatal period and how that affects the birth. Learn vital palpation skills. Prenatal care is essential for normal birth.
How and why birth works the way it does. Research as well as some of the many variations of normal will be covered.
Learn about the hormonal physiology of third stage, impact of early separation, and long-term impact for mother and baby on breastfeeding and attachment.
Suzanne will discuss how to look, listen, know and act to prevent problems. She will present effective ways to inform and educate your clients about potential complications and methods of handling specific complications as they arise.
Learn about how we can develop the trust necessary to allow the patient unfolding of the birth process, while remaining alert and prepared for any problems or complications.
We begin our journey with movement, music and dancing our babies into the world. We will discuss the path to ecstasy: the hormonal cocktail of labor, birth and breastfeeding and what can disturb them. Learn how the key elements of privacy, safety and being unobserved and undisturbed facilitate an easier, gentler birth. Learn how to create birth ambiance: lighting, music, aromatherapy and touch. Learn the 4 R’s of labor: relaxation, rhythm, ritual and rebozo, along with the Hoku acupressure point. Debra will discuss the research behind physiological second stage and the use of squatting, lap squatting, kneeling, tug of war, and the rope.
Fear in pregnancy and birth can have many consequences for both the family and health care provider. The most powerful and effective item we carry into the birthing room is how we feel about birth. This class will help you define, understand and move through the fear that confronts us. Learn several ways of helping women, including midwives and doulas, turn fear into trust. We will discover ways to release fear, finding comfort and pleasure in our work.
Eneyda will cover basic prenatal massage strokes, body mechanics, and precautions and contraindications of prenatal massage. These include Swedish and support massage strokes you will need for prenatal, labor and postpartum care. You will learn how to use your hands and body correctly in all the support positions you use, as well as the physiological and energetic contraindications of hands-on support for pregnancy, labor and postpartum care. You will also learn about a massage for restarting stalled labor and use of the rebozo in birth care. Bring one or two pillows, a flat sheet and a small hand towel.
This full-day class brings together several lectures along with small group activity to apply the principles to professional practice or personal experience. Topics include: hormonal orchestration of labor, the impact of interventions, the hour after birth, and much more.
All are welcome.
Tuesday • 21 June 2016 • Pre-Conference
Gail will discuss the mechanical, physical and emotional causes of shoulder dystocia. She will describe symptoms, and how to determine if it truly is shoulder dystocia. She will analyze tools and methods used to overcome panic reactions, demonstrate effective treatments, and look in-depth at maneuvers to predict and correct it. Gail will discuss incidence rates and ways to prevent it. She will discuss how to quickly identify dystocia when it occurs and how to enlist the help of the mother to deliver her child in an atmosphere of calmness and strength. This class goes beyond traditional teaching of shoulder dystocia.
Gail will share the protocols and techniques they use to help the mother move through labor. This discussion will include prolonged rupture of membranes, failure to progress, abnormal labor patterns, non-medical intervention and more. Listen to these experienced midwives discuss constructive and effective ways to handle both normal and difficult situations. Bring your questions and experiences to what promises to be an exciting session.
Miraculous Beginnings is a celebration of pregnancy and birth where moms and dads have the once-in-a-lifetime opportunity to be conscious participants in this miraculous creative process. When parents, together with their midwife or other health care provider, celebrate the gift of conceiving, schooling in the womb and delivering a child, we all become part of this beautiful process. From this perspective, pregnancy and birth are what they are meant to be—joyful and sacred, with mom, baby and dad actively participating in the miracle of creation.
We will begin this workshop with a discussion of how to turn breech babies. This class will also address the skills needed when attempts at turning don’t work, and the parents and midwife decide to do a vaginal breech birth. Although breech birth is not for beginners, everyone is welcome in this class because you never know when one will surprise you. We will cover palpation skills, estimating fetal weight, amniotic fluid, and how to communicate with the baby through touch and words. We will cover basic skills including the hands-off approach and how to handle problems while staying calm. Frank, footling and complete breech will be discussed, as well as cord prolapse, fetal heart tones, intrauterine growth restriction (IUGR) and other complications of breech presentation. You will be exposed to ideas on using waterbirth for breech.
In this course we will organize and discuss instituting the best practices and organizational methods of midwifery and birth for the South Seas. Taking inventory of the way things are done now, we will discuss the best way forward for bringing the best evidence-based practices to the islands.
We’ll start off this session with the facilitators each sharing a quick story of facing a complication and finding their way to a successful outcome, with a midwife’s inner resources and knowledge. Role play will be used. Next you may share techniques you’ve used in your practice or bring questions you have to this roundtable of tips on a wide variety of topics. Previous sessions have included facilitating effective contractions, dealing with prolonged labor, preventing perineal tears, helping the slow-to-start baby and holistic first aid. This is always a much-appreciated session, for its sense of sisterhood and inspiring information.
Wednesday • 22 June 2016 • Conference Day One
The way we are treated in the womb as well as at our birth has far reaching consequences to our whole lives. We want to make sure love is given and felt from the very beginning of life. We will learn more about how to manifest that God-given love to our babies and as midwives to the families in our care. Come celebrate with us!
We need to strengthen the midwifery associations and make them more viable and visible. We want to teach midwives to think on their own and to develop autonomy and strong practice. A report from our pre-conference workshop will also be given. A short presentation by Jan Tritten will be included about the Inuit model wherein birth and midwifery was brought back to the community thus solving many social ills.
Fiji and the South Seas are ideal places to develop waterbirth practices. We will explore the many benefits and ways of using water in birth and will discuss its unique properties—psychological as well as physical. Waterbirth is not only an option for a woman to give birth undisturbed and in dignity, but it has medical advantages for mother and child. Breech births, OP births and twin births benefit from waterbirth. Breech waterbirth needs no hands, no extra warming for the newborn’s body or other interventions. The ease of attending births in water is a joy.
Long labors may be associated with complications ranging from social or emotional issues to physical problems. Gail will discuss different reasons for prolonged labor, how to detect the pathological labor from the simple prolonged labor, and how to overcome difficulties and correct problems when possible or facilitate transfer when needed.
We will explore the time after birth for mother and baby, including the normal hormonal orchestration at this time, designed to enhance long-term survival of mother and baby. The impact of cord clamping and/or separation of mother and baby will be explored. Included will be evaluating active management of third stage vs. physiological third stage and treatment of hemorrhage.
According to emergent scientific disciplines, we know the following: Newborn babies need maternal love; this need has been ignored for thousands of years (routine separation of mother and babies, delayed initiation of breastfeeding, etc.). Newborn babies are supposed to be colonized by friendly microbes that immediately educate their immune system: until recently all microbes were considered enemies. Until recently the word “stress” had an exclusively negative connotation; however, the stress induced by uterine contractions has a positive role to play in the development of human beings.
Analyzing the various techniques used around the world brings the surprising conclusion that neonatal resuscitation methods are a cultural, not a scientific, norm. The experiences of what works in one hospital unit is often different from another unit in the same city, and practitioners who work in both home and hospital know they often do things differently depending on the setting. Let’s examine the concept of safe and effective physiological resuscitation methods that don’t require high technology for implementation.
Every caregiver wants to be prepared for “anything and everything”! Fernando will share his experiences to illustrate assessment techniques, problem solving and ways in which practitioners can build their self-confidence in dealing with various emergency and unusual situations. Fernando will present ways to be more prepared for uncommon complications that you may encounter: unusual bleeding, thrombocytopenia, meconium, neonatal jaundice, hematoma formation, signs of embolism and more. Learn how to manage these while keeping the family and yourself calm. Bring your questions and cases to study.
Women who are coping well with labor have some things in common: relaxation, rhythm, ritual and rebozo (the 4 R’s). Debra will describe the 4 R’s and the many ways women experience them. Enjoy time to practice hands on techniques as you try different positions with a rebozo and discover rituals to ease labor and help motherbabies create a safe, satisfying birth experience.
Suzanne will explain her view of birth from a broad perspective, and detail the benefits of normal, natural, physiologic birth for mothers and babies. She will cover the hormonal physiology and also the importance of gut flora transfer from mother to baby for lifelong immune and brain function. Evolutionary and psychological perspectives will also be discussed.
One of the keys to joy in midwifery practice is autonomy. It is essential that midwifery be an autonomous profession. Learn specific ways in which autonomy can help birthing women reduce unnecessary and risky intervention in birth and keep joy in midwifery practice. As autonomous midwives we are free to modify practices when new evidence is learned about different areas of practice. Without autonomy we often end up stuck in “standard of care” protocols that are not evidence based.
We will meet in groups and report back on our discussions and decisions. Please join us in this global visioning session for birth and midwifery. We will break into small groups to work on issues. Each will have a facilitator. These are not classes but work groups. Bring your ideas. We will meet in our work groups for an hour and a half and return with a short report from each group. Work group topics may include but are not limited to the following:
Thursday • 23 June 2016 • Conference Day Two
Our microbiome is essential for our health. Birth and early motherbaby contact is critical for seeding the microbiome for the newborn. This session will discuss the current research and debate about the influence of the microbiome on health, and will offer practical recommendations about how we can promote and support a healthy microbiome for newborns.
This is a two-way street. Studies have shown that every unborn child has profound and significant experiences in the womb, establishing patterns of interactions, listening to conversation and music, and actually memorizing them. The womb is a stimulating place and functions as a school, where babies form strong relationships with their parents and vice versa. To communicate effectively with the unborn child, parents must also be aware of how their babies are communicating with them.
In this session we will focus on three common birth variations. The physiology and current research relating to each variation will be discussed. Midwifery practice will be explored including minimizing risks and identifying and managing complications.
Discover low-tech ways to make birth safer in those regions where the technology simply is not available, or to prepare to be able to provide care during a national disaster. Do you know how to work without medications or IVs? What would you do if you did not have your equipment and supplies at a birth? Would you be lost without your “stuff”? Let’s look at what is truly essential for birth, which routines can be abandoned or modified, and how we can improvise when necessary.
This is an in-depth look at malpresentations and mal-rotations; their likelihood and causes; palpation methods to identify them and the techniques for assessing and dealing with them. You will learn many tips for helping remedy these errant babes to move into better position for vaginal birth. Bring your techniques to add to this body of midwifery knowledge.
The South Seas is a perfect place to develop village prenatals. Village prenatals have a sole purpose: We gather out of selfless service to support and encourage the instinctual life of pregnant women who are trying to birth in power against a modern current of fear and an environment of perpetual interventions. We are there to shower them with village attention and support and to bathe them in the sense of belonging and being cherished.
[In case you missed the pre-conference class.] Do you know that the clues of impending development of shoulder dystocia can help us prevent its occurrence? Gail will discuss the mechanical and physical causes of shoulder dystocia; the associated risk factors; the symptoms and signs to predict it; how to prevent it; and how to remedy it. She will analyze tools and methods used to overcome panic reactions and demonstrate effective treatments. Come learn Gail’s new methods.
Explore the many benefits of homebirth and the skills required. Carol will present different ways to provide the homebirth client with the highest standard of care. She will explore the homebirth model and why it is excellent for mothers and babies. She will explain how to go about setting up and maintaining a homebirth practice. Carol is a homebirth midwife who has been in practice for nearly 40 years.
During pregnancy, labor and birth, a woman is full of creative energy—she is full of life! This session will explore the many ways to use creative expression to help women and their partners prepare for a safe, satisfying childbirth experience. Learn how to use art, dance and singing to help families express fears and release emotions. Learn about ways to educate and inspire parents to prepare for labor, birth, breastfeeding and parenting.
“Why is this procedure necessary?” The two most dangerous answers are “That’s the way I was taught,” and “that’s the way I’ve always done it.” Our panel reminds us that midwives are helpers in a natural process. By learning from women, we are able to anticipate problems and keep complications from developing. Trusting in the simplicity of birth, we become true midwives, midwife-physicians and guardians, rather than manipulators of birth.
Come learn from midwives and physicians how love can be manifested whenever you care for motherbaby and each other. Love is possible even in the worst situations; it can be taught, it must be modeled, and it can change the world! It all begins with respect—and every mother, baby and family deserve respect.
Brainstorm with us and your peers on how we can effect changes in midwifery and childbirth on the global level. Learn about the midwifery and birth movements going on around the world and how you can help. We can make changes for the better with knowledge of global possibilities. We will share techniques, systems, and political and educational ideas that will help you further the midwifery model in your sphere of influence. A discussion of the Global Midwifery Council, iBirthToday and the International Alliance of Midwives will be covered.
Friday • 24 June 2016 • Conference Day Three
Interventions—however well-intentioned—have a great impact on the hormonal orchestration of birth. Interventions that greatly alter the physiology of birth include epidurals, cesareans, induction and separation of mother and baby after birth.
It is important to understand the full process of third stage and to facilitate the delivery of the placenta correctly. Let’s look at the evidence and learn techniques used where routine oxytocic’s are not accessible and which render the need for pharmaceuticals rare. You will learn about how to assess third stage and deal with complications to reduce the risk of excess blood loss. You will also learn about how to assess and deal with bleeding in a way that will increase your confidence—by actually estimating with real blood in and on different materials, such as on pads and in water. We will also talk about using the placenta, cord and membranes for hemorrhage control.
The 3 P’s of childbirth education are passion, practice and physiology. Learn about the key elements to weave enticing, educational classes into your practice. Learn fun ways to provide information so women and their partners can make the best informed choices for their birth as you empower them to release their fears and give birth with confidence and joy.
Learn how undisturbed birth is inherently sexual in nature and how even our well-intended assistance can interfere. Develop a deeper understanding of oxytocin and its relationship to adrenaline by seeing how these hormones function at other times in the lifecycle, including the postpartum period. Share sexy birth stories and come away with new ideas of how to promote transformation and pleasure in birth.
Suzanne will discuss strategies for safe twin birth, including positioning, time of delivery, premature delivery and avoiding postpartum hemorrhage, as well as special aspects of prenatal care. Suzanne is gifted at both covering the “how to’s” and telling amazing birth stories.
In this well-loved Midwifery Today format, you’ll sit in on three interesting and inspiring roundtables of your choice. Roundtables will include:
Women’s and babies’ human rights have been violated in today’s birth environment. We need to take a long hard look at our practices and protocols and make sure we are putting motherbaby first. Join us to discuss how we can establish good birth practices that respect human rights. It is way past time. We will review the many ways we can be with women, giving them respect, dignity and informed choice. First, do no harm.
Let us use all of what we learned at this conference and take that love back to our communities and we will begin to transform cultures into more loving and happier places to live!
Closing Remarks: Jan Tritten
Introduction of Chief Guest: Registrar Fiji Nursing Council
Address by Chief Guest: Hon. Jone Usumate, Minister of Health
Vote of Thanks: General Secretary; Fiji Nursing Association