Midwifery Today Conference
Bury St. Edmunds, UK • 26–30 May 2014
“Midwives Hold the Future”
Monday • 26 May 2014 • Pre-Conference
Women believe they can ensure the well-being of their babies by reporting for an early ultrasound scan. This is not necessarily so, and there are a number of studies that show early detection can be harmful. Jean Robinson and Beverley Lawrence Beech wrote the book Ultrasound Unsound, in which they reviewed the research evidence and drew attention to some of the hazards. More evidence has accumulated. Come learn about this important subject.
Our teachers will discuss the mechanical and physical causes of shoulder dystocia. They will describe symptoms and signs to predict it. They will analyze tools and methods used to overcome panic reactions. They will also demonstrate effective treatments. Gail will look in-depth at more than 14 maneuvers for shoulder dystocia, and cover mnemonics and the latest research. Learn to identify different types of presentations, their likelihood and causes. Discover techniques for assessing and dealing with them. You will learn many tips for helping so birth can move forward and be achieved. Bring your techniques to add to this body of midwifery knowledge.
Verena will present a systematic approach to pain relief, based on physiology. We need to offer women a new midwife-led service of pain relief in labor without the risks of medical interventions. Physiological hypoalgesia is a third option between epidural and medicalized painful birth and offers women a choice. We will analyze a woman’s need for pain relief and for a normal birth in different settings and offer an individualized answer to her needs through a systematic approach. Old and new techniques of hypoalgesia are analyzed and linked to the three neurological dimensions of labor pain, to the principles of Grantly Dick-Read and to the laws of physiology. You will have the opportunity for direct experience with some of these methods. We will also set the foundations for a prenatal training for coping with pain.
Learn to spot a long labor before labor begins and turn it around to a shorter labor. This course goes beyond Optimal Fetal Positioning with the 3 Principles of Spinning Babies: Balance, Gravity and Movement in pregnancy and in labor. Compare anterior and posterior fetal position. Practice labor progress techniques appropriate to the level of descent and tell whether a cesarean is needed or just more time. Fewer cesareans/fewer transports may be possible now. “When I took Gail’s class I knew we had to have this amazing teacher join us in Midwifery Today conferences.”—Jan Tritten. Wear comfortable clothing. Please bring massage tables if you have any available.
A whole college course in a day! This workshop offers an overview of the exciting sub-discipline of the anthropology of reproduction from its early beginnings to its latest findings. We will concentrate on anthropological studies in four major areas: childbirth, midwifery, the new reproductive technologies, and the politics of reproduction. Robbie will describe the works she considers to be key in each area and summarize their findings, and will suggest important directions for future research. Her goal is to provide a stimulating overview of these anthropological subdisciplines for midwives and others who want to know what the social scientists are up to, and to accompany that overview with an extensive annotated bibliography that will provide a helpful template for further exploration and research.
All are welcome.
Although women allegedly give informed consent for the use of drugs used in labor, the reality is that the majority of women have little information about those drugs. The propaganda promotes the “advantages” of drug use, but little is said about the long-term effects. It is those effects I will examine. All drugs have unwanted effects!
Tuesday • 27 May 2014 • Pre-Conference
Verena will discuss maternal positions, various methods of “pushing” and effects on the mechanism of labor. This class is designed to help you understand the pathway through the pelvis and the transformation of the perineum as the baby makes his or her way into the world.
These classes are designed to improve and enhance your midwifery skills and knowledge. This is a great class for beginning and advanced midwives.
Learn how to evaluate and nurture the emotional, physical and psychological well-being of pregnant and birthing women. Prenatal care is vital to normal birth.
You have set the stage for good births in prenatal care. Learn to identify your own risk criteria. Learn to look, listen, know and act to prevent problems. Learn how to handle specific complications as they arise.
Learn how to facilitate exalted states of birth, first of all by not disturbing the mother.
Learn to work with emotional issues that have a profound impact on the progression and outcome of labor.
Sharpen your skill in handling the newborn. Learn how to assess and then how to handle newborn complications, including how and when to transport.
Learn 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.
Michel will teach you how to look at birth through the eyes of a physiologist, which is a valuable skill for any midwife or doula. In an easy-to-understand manner, he will cite important findings from many areas of research and explain how this information can affect mothers and babies, not only during birth, but also over the course of their lives. Scientific data proves midwives help to keep birth safer for mother and baby. Evidence-based practices can improve birth outcome by helping mother remain the center of her birth. Learn the science that supports midwifery methods such as skin-to-skin contact, physiological pushing, optimal positions for labor, delayed cord clamping, family bonding and “the newborn breast crawl.” There will be time for questions and discussion following the presentation of leading-edge research and analysis of current problems.
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 or home 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 and hands and knees 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 and recognizing intrauterine growth restriction (IUGR) and other complications of breech presentation.
The origin of these techniques and traditions from Mexico goes back thousands of years. We will learn how to use a rebozo, a useful tool in all parts of the childbearing cycle. In this amazing class you will discover simple techniques that promote healthy pregnancy and birth. You will learn many “new” old techniques you can apply immediately to your practice. Time for hands-on practice will be provided. Thea and Mirjam co-wrote the book The Rebozo Technique Unfolded, with preface by Naolí Vinaver.
We will explore the art of being a relaxation specialist for labor. Comfort measures for labor such as hydrotherapy, massage/touch, visualization, movement, toning and the birthing ball will be discussed. Learn comforting and calming techniques to support your clients through all stages of labor with confidence, resources and hands-on and hands-off skills. Learn to listen and react to their needs, even when non-verbal, through listening with your heart and intuition. The focus here is pain relief; support, respect and helping mothers stay calm and focused.
Come listen to this very important class knowing that even though a woman may be having a complication, she is still having a baby and needs to be treated with care and respect.
Wednesday • 28 May 2014 • Conference Day One
We are integral to a healthy society by helping one family at a time. As each motherbaby begins to have their best birth possible we will begin to see civilization change. There is hope for the future and midwives and doulas are an important part of that hope. We are the change agents.
Have you ever noticed that textbook knowledge of the behavior of the cervix bears little resemblance to how real women’s bodies behave?! Sara explores knowledge from women, midwives and research and shows how new insight, evidence and knowledge challenges conventional notions of appropriate progression in labor.
Childbirth does not need to be a painful experience. Much of the pain in childbirth is caused by fear and anxiety. Fear increases tension, which increases pain, which increases fear. Midwives and doulas can use methods to reduce fear and tension in order to reduce pain. Most women can be relatively comfortable throughout labor if they have tools for relaxation, support and confidence.
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 in a couple’s sexuality and pleasure in birth.
What is the homebirth model and why is it the best? How can we apply this model to other settings? Explore the many benefits of homebirth. Betty-Anne will present a review of the research.
In an understaffed and pressurized service, it is easy to develop ways of coping that can damage us and the women in our care. This session aims to provide a safe space to explore positive skills for coping and for working to change services.
This is a fantastic tool to get labor restarted. You will wonder how you practiced without it. “I saw this work at a birth in Mexico where Verena and I were present. This labor had stopped entirely at about 7 cm. Verena did this massage and the labor restarted. The woman had her baby a couple hours later,” says Jan Tritten.
What to do when the due date comes and goes? What are the real risks of prolonged pregnancy? How do we assess for signs of postmaturity syndrome? How do we know when it is time to intervene; and how do we intervene when it’s needed? Let’s look at what the evidence says about risks and how to mitigate them, discuss how to monitor the prolonged pregnancy, and learn how to balance protocols with common sense. Also covered will be how to calculate due dates as accurately as possible, and how to determine fetal well-being.
In the medical realm, ritual takes on special importance. It defines appropriate procedure, indicates proper training and competence, and serves as an essential buffer against the fear of dealing with out-of-control natural processes. Ritual’s courage-enhancing and habituating effects can be used wisely in medicine. At the same time, the most sincere efforts at humanistic reform can be completely thwarted by subtle and often unconscious adherence to rituals that work to maintain the status quo. Conscious awareness of ritual’s power to serve individual patients or subsume them to institutional routine, to facilitate change or stop it cold, can leave medical practitioners free to choose.
In these busy times, it can be challenging to find the time to keep up with new knowledge. Stay up-to-the-minute by joining Sara in a discussion of evidence and midwifery knowledge while on a tour of 10 recent childbirth-related research and discussion papers covering topics relating to pregnancy, birth and the postnatal period.
One of the reasons the notion of looming risk in birth seems to steadily increase is that care is infected by fear. Caregivers do experience trauma caused by true accidents of birth, mistakes, peer pressure and patient’s reactions, yet oftentimes they do not have true debriefing opportunities. Addressing caregivers’ emotional triggers can help them be better caregivers. We will discuss ways to process traumas to minimize the negative impact on clients’ births.
Gail will discuss the physiological causes of shoulder dystocia. She will describe symptoms and signs of five types in three levels of the pelvis. The FlipFLOP memory tool is introduced, which is sure to reduce panic reactions. See how recent research supports physiological resolution of shoulder dystocia with rotation and bringing out the posterior arm. Come practice.
In the closing decades of the twentieth century, the “scientification of love” had offered plausible interpretations of long-term consequences of the way babies are born. Today, sudden advances in bacteriology are stimulating a still more spectacular turning point in our understanding of Homo sapiens, and particularly of childbirth as a way to enter the world of microbes. From a bacteriological perspective, the perinatal period appears as the phase of modern human life that has been the most dramatically turned upside down. In the framework of the “microbiome revolution,” there are reasons to anticipate fast and profound transformations of our species in relation to the modes of birth.
Share the techniques you’ve perfected in your practice or bring your burning questions to this roundtable of pertinent 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 as well as its information. “Worth at least two weeks of academic training,” said one participant.
Thursday • 29 May 2014 • Conference Day Two
Although laid-back breastfeeding is central to the concept of biological nurturing, BN is much more than a position. Learn more about the other components or active ingredients in this new breastfeeding approach. Find out about Suzanne’s original PhD research and the ideas that have revolutionized the field of breastfeeding support. Stay on top of leading-edge research. The video clips that support the BN concept challenge the very foundations of breastfeeding management. Think outside the box and study the supporting evidence for biological nurturing.
Hal David had it right: “What the World Needs Now Is Love.” In this aggressive world, the need for love is great. Learn what we can do in our role as midwives to help promote love.
Fear in pregnancy and birth can have many consequences for both the family and health care provider. 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.
Asynclitism is a common cause of failure to descend. Some years ago, in her talk, Occiput-Posterior (OP) Myths, Penny Simkin said we need more techniques for asynclitism. I listened and practiced and now feel I have something to share. Learn why this happens and what to do about the tipped head. Slides will help you visualize what is happening. There will be time to practice techniques presented.
How do we get a long labor to progress? Long labors may be associated with complications ranging from social or emotional issues to physical problems. We will learn different reasons for prolonged labor, as well as methods for helping women move along in labor. Learn methods to help detect the pathological labor from the simple prolonged labor. Analysis of myth and reality will also be discussed.
What can the story of the “Three Little Pigs” teach us about childbirth? Why is “the big bad wolf” the focal point of the story, and what does the wolf stand for, metaphorically speaking? Come and learn about birth in evolutionary perspective and how present concepts of childbirth and midwifery need to integrate premodern understandings with a postmodern perspective!
Although birth is usually characterized by rupture and change, the theoretical framework supporting biological nurturing is underpinned by important aspects of continuity from fetus to neonate, and from pregnancy to birth. What we do as midwives, doulas and lactation consultants in the moments and hours after birth can either enhance or hinder mothers’ and babies’ needs—even with a gentle birth. This session will explore the physiologic basis for immediate and continuing mother-baby contact, introducing some biological nurturing variables that have traditionally been overlooked in the mainstream literature. “First, do no harm” applies to breastfeeding as well as to birth.
Analyzing the various techniques used around the world brings the surprising conclusion that neonatal resuscitation methods are a cultural, not a scientific norm. Both culture and technology influence beliefs in resuscitation methods, sometimes putting a higher priority on organizational instruction than on evidence of effectiveness. In recent years some methods have done almost as much harm as good. We will discuss the different techniques and different cultural understandings and present the concept of safe and effective physiological resuscitation methods that don’t require high technology for implementation.
Mothers often know their baby’s position by late pregnancy, even without help, but may need words and concepts to recognize the position through the bumps and wiggles they feel. The midwife, doula or childbirth educator introduces positive messages while teaching families about belly mapping. Mothers enjoy belly mapping as a bonding tool or to apply optimal fetal positioning as proactive childbirth preparation.
What do doulas do? Learn the different kinds of doula trainings available in Europe. How do doulas train to keep birth normal? Understand how doulas can improve birth experiences for everyone involved by guarding the hormonal component of birth. Doulas help keep stress down and confidence up—which equals better physiology. Doulas also learn to be profoundly respectful of parents’ history and belief system and work within these to facilitate an informed and altogether better experience of birth.
Jane 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. The teaching of “how to” skills as well as the telling of amazing birth stories are a gift Jane gives us.
Learn how we can really effect changes in midwifery and childbirth on the global level. Learn about the midwifery and birth movements around the world and how you can help.
Gail will share her brilliant insights and findings on the hormonal states of mother and baby and the interaction that occurs. She will cover how we can facilitate the process without disturbing motherbaby. Gail’s teaching on this subject makes it a fascinating class. Her insights can help you improve your practice.
Midwifery students, and even midwives and nurses, will enjoy this basic class on perceiving fetal position through your fingers. Bring your tips…not only at the end of your fingers, but the tips on palpation you’d like to share with the next generation. Pregnant volunteers will be sought out for class, but be ready to palpate one another, too, if need be.
Attending Brownies and swearing in our childhood promises to “do my best to God and the Queen, to help other people at all times,” might have had more influence than we know on how to fight for our ideals and still fit into status quo society. When health care professionals define terms of engagement, women can be quickly stigmatized as needing help, advice and control, and the paternal professions often assume a role of needing to save them. Bureaucracies tend to use auditors who will ensure that midwives are imposing the required interventions on their clients, while midwives follow the informed choice pillar of their profession, interpreting “no” as meaning “no.” Betty-Anne will present a case in Ontario in which varying auditors defining informed choice differently weigh in on whether a midwife can continue to practice, and how her community of midwives has come to her defense, based on the ideals of offering informed choice. The case has gone on for six years without an end in sight.
This class will affirm the knowledge and the power we contain and express through our hands. It will remind you that the essence of midwifery is, after all, its hands-on approach to providing care, support and education. It will give you confidence to use your senses, to keep your heart open and to listen. Gain skills that involve the sense of touch. The practical use of hands will be discussed; you will be reminded that hands are also tools of emotional support and love.
Brainstorm with us and your peers on how we can really effect changes in midwifery and childbirth on the global level. 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, the Birth Revolution and the International Alliance of Midwives will be included.
Open to all registrants The cabaret is for everyone to show their many talents whether in song, dance or whatever you do that you would like to share. The cabaret is really fun!
Friday • 30 May 2014 • Conference Day Three
For their co-edited volume, Birth Models That Work, Robbie and Betty-Anne chose international models of practice that provide a solution and counterpoint to the dominant technocratic birth paradigm. Each story is testimony to what a small group of idealists can do to create model childbirth practices and educational programs for practitioners. In this presentation, they will describe some of those models in Canada, the Netherlands, New Zealand, Japan, Mexico and Samoa. For their second, forthcoming volume, Birth Models on the Global Edge, Robbie and Betty-Anne have become even bolder in introducing models that challenge modern orthodoxy with unanticipated success! These models from low-resource countries draw attention to the presumptions and presuppositions of models in high resource countries. They include models created by unique communities in Afghanistan, India and the Nunavik region of Quebec, and models that address controversial contemporary issues of clinical practice, such as vaginal breech birth.
Learn how to start and organize your practice. Rudite started the first independent midwifery practice in Latvia, offering pregnancy care and breastfeeding support, as well as attending homebirths. She will share her wisdom from many years of building a practice: expanding contacts, developing communication and sharing experiences.
Many episodes of excessive blood loss are either preventable or foreseeable and easily controlled. It is important to facilitate the delivery of the placenta with patience. Learn techniques and approaches that render the need for pharmaceuticals rare. You will learn how to assess and deal with bleeding in a way that will increase your confidence.
Learn how to create a nurturing environment for women at hospital births. Study the issues, obstacles and concerns. Plan strategies that will protect and nurture women. Learn how to protect motherbaby from unnecessary interventions.
Eneyda will explain why massage is essential for pregnant and birthing women and show practical application. She will discuss the importance of healing touch as a preventative tool and safe remedy for the pregnant, laboring and postpartum women. Come join this class where time for hands-on practice will be provided.
Obstetric emergency courses are great, but they tend to assume you’ll be in a hospital room with a bell that summons a handy multidisciplinary team. In a woman’s home, the landscape changes and we need different ways of thinking and doing. This session, which incorporates discussion of real-life scenarios in a safe space, is a taste of the homebirth emergency study days that Sara Wickham and Penny Champion run for midwives. You will also find out why all emergencies are not equal, which three skill sets you need to prioritize and how gaining knowledge can reduce fear.
In this well-loved Midwifery Today format, you’ll sit in on three interesting and inspiring roundtables of your choice. Roundtables will include:
The art of midwifery is the essence of birth care. The more industrialized we become in birth, the further away from our true calling we are pulled. Join us at this closing session, as we redefine and reclaim who we are in our efforts to help women and their babies. This reenvisioning will inspire us to think about ways to use our art to reclaim our authentic midwifery selves. “First, do no harm,” must always be our foundation.