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Back 4 June 2014

Education: the Bridge to Midwifery and Women's Autonomy

The fourth day of Congress started with an interesting and vibrant session titled ‘midwifery practice is driven by women’s wishes/choices’. Four midwives from different cultures debated whether women and informed consent are at the centre of global midwifery care, or whether it is health/government organizations and midwifery’s needs that drive practice. Margaret McGuire, Co-Chair of the ICM Scientific Professional Programme Committee led the session, and the four speakers were: Judith McCara-Couper (New Zealand), Jemima Dennis-Antwi (Ghana,) Franka Cadee (Netherlands), Address Malata (Malawi). Judith started the debate saying that at the heart of midwifery is the strongly-held truth that women are informed of their choices and supported in the choices they make. ‘If midwifery practice is not driven by women’s choices, what would it be driven by? Can we imagine such a situation?’ Women’s choices are however influenced by social and cultural context. Judith stated that women are encompassed in a society that encourages surgery, pharmacology, and technology. She ended her speech saying that ‘women’s choice across the spectrum of practice, albeit culturally-influenced, is driving the practice of midwifery’. On the opposite side, Jemima Dennis-Antwi said that women’s choices are not the centre of care, but organizations are. ‘If politics undermine the situation, how can women have a choice? How can women’s choices prevail under social oppression’, stated Jemima. In some countries, politics mean women and midwives have to leave their countries and be refugees. Money is often not channelled into health care, in particular maternal care. ‘How often are we, as midwives, involved in the design of public health facilities, in order to advocate for women’s choices?’- was a question raised by Jemima. The midwife deficit in the world shows that midwifery today is not supporting women’s choices, thus many women have no choice. ‘In the circumstances that midwives find themselves in, it may be difficult for them to provide woman-centered services’. Franka Cadee carried on with arguments in favour, and said ‘midwives are women-driven, we support the woman to get what she needs’. Address Malata was the last speaker to present her arguments, she stated ‘many of our guiding documents have very weak attitude components’. She added that women cannot make choices, ‘we cannot argue if midwifery is driven by women’s choices if we don’t have enough midwives’. Address provided her home country Malawi as an example, where the vacancy for midwives is at 75%. After the four speeches, the floor was open to questions from the audience and debate, bringing life to the session. The majority of attendees agreed that midwifery care is not currently women-centered, however everyone agreed that it should be. Read the full update here.

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