Serena Debonnet, Baby Friendly Hospital Initiative (BFHI) co-ordinator for the Federal public service in Health, Food Chain Safety and Environment in Belgium, president of the Belgium Association for Lactation Consultants (BVL) and former vice-president of the Flemish Professional Organisation of Midwives.
Brief introduction to yourself, including member association, area of interest and expertise and why you decided to become a midwife:
I graduated as a registered midwife in 1994 in Leuven, Belgium. Since childhood I was fascinated about the human body and excited about how a woman can give birth and feed a baby. I realised that be with women and support families during this period in live was what I wanted to do.
Being a midwife has changed my life. I took my responsibility to stand up for the rights for the midwives in Belgium. A few years after graduating I became Vice President of the Vlaamse Beroepsorganisatie van Vroedvrouwen. In that position we lobbied as a group to be the voice for all the Belgian midwives. We have achieved a lot with the support of the Member Association: skilled, autonomous and competency-based midwives work with a high level of education and are confident in their work. The Belgium National Committee has an advisory function to the Minister of Health and the work fields are very wide for midwives. We see more midwives working in menopausal consultancy, lactation and beyond.
I have been elected as an ICM board member in 2014 and was re-elected by my group, Central European region, in 2017.
In my preschool training I really missed how to counsel a pregnant woman about breastfeeding and how to assess and support breastfeeding. I was so curious about the mystery of human milk and its benefits that I went back to school to learn more about it.
I became passionate about the use of human milk and attended in 2004 & 2014 the exam to become a lactation consultant with the International Board of Lactation Consultant Examiners (IBCLC). Even now, I believe there is something so powerful and natural about the use of a mother’s milk. Human milk for every child can make a different in the world.
Looking at the United Nations Sustainable Development Goals, there is an important place to prepare and support breastfeeding, especially in the industrialized countries where industry and publicity is influencing new families. As midwives, we have the responsibility to help so that every mother can reach her own personal breastfeeding goals. As a mother, I had my own breastfeeding story - with a difficult start, but a lovely end - after 2 years.
Over the last 15 years I have worked as the Baby Friendly Hospital Initiative (BFHI) co-ordinator in Belgium for the Federal public service in Health, Food Chain Safety and Environment.
I’m assisting and coaching the hospitals to integrate the World Health Organisation ‘Ten Steps to Successful Breastfeeding’ into relevant policy documents and professional standards of care.
I’m very enthusiastic about the several opportunities I have got to promote breastfeeding in Belgium and worldwide. In 2016, I became the president of the Belgium Association for Lactation Consultants (BVL).
What issues do you think impact the life of women and their newborns the most in your country?
Belgium has a high performing health system; some indicators of health status and quality of care are amongst the best in Europe (OCDE). We can still do better on strengthening prevention and primary care.
Pregnancy usually is quite a joyful experience of a very natural physiological happening. Unfortunately, it has become highly medicalised in our Belgian society. The Belgium Health Care Knowledge Centre has several publications to optimise the quality of care for woman and child. Guideline relative to low risk birth (KCE reports 139) and What are the recommended clinical assessment and screenings test during pregnancy (KCE Reports 248) are both clinical practice guideline concerning normal birth in healthy women.
Since 2005, we have seen the support of breastfeeding as a national responsibility and have put a lot of effort in the implementation of the BFHI guidelines. We created a special agreement for the breastfeeding competencies of health professionals with continuing education and in -service training.
We do not forget the vulnerable and sensitive premature newborn and their special needs.
What programmes currently exist in your country to support women and newborns, and do you think they are working? Why or why not?
With the support of the federal public service and in collaboration with the Midwives’ Association, there is been put a lot of effort in the support for breastfeeding and the newborn individualised development care after a premature delivery. Quality of care needs good guidance an adequate staffing in hospitals and a multidisciplinary collaboration.
What could be improved by Governments and the public to save more lives of women and newborns?
Worldwide extreme inequality kills people; I believe that governments have the obligation to put all effort’s and advances to full gender equality.
Girls find themselves vulnerable and need extra support to develop, to start education and training and to become a powerful woman. Girls’ education has a huge impact on all of society! Investment in education can save the life’s during childbirth and provides the world with healthier children. We must prioritise empowering girls and woman to make intelligent decisions in life for themselves and for their newborns.
We must invest in midwives and create better working conditions for midwives in all settings to ensure more one-to-one support for new mothers and babies, and facilitate a safe first skin-to-skin contact between mother and newborn immediately after birth.
We must go for respectful quality care and never stop learning.
What could be improved by Governments and the public to support midwives in delivering high-quality, respectful maternity care?
I’m convinced that Respectful Maternity Care is central to health and wellbeing and must include the protection of the human rights. It’s our responsibility to inform every woman so she knows that she has choices. As midwives, we need also the freedom to speak about the physiology of giving birth and the hidden danger of over-medicalisation during childbirth.
Governments must make the commitment to protect and support the evidence-based quality care provided by midwives.
Education that empowers the student midwives and create an autonomous responsible healthcare giver is an important goal to reach. Midwives must be able to go into dialogue with obstetricians and allied health professionals without being afraid of the existing hierarchy, as this is still an actual problem in several countries.
We all have a role to play in saving mothers and newborns. We need to use our knowledge every moment. We can save lives by starting immediately skin-to-skin contact after birth as it prevents the mother from hemorrhage and it helps the newborn start life with the healthiest feeding.
Governments need be reminded to the basics of life and their importance, because every woman has the right to quality healthcare where they are treated with dignity and respect. In Belgium particularly, this means equality for midwives no matter where they work. The new job classification IFIC divides midwives into several groups depending on their workplace: labor room or maternity care. Due to the new functional qualification system IFIC, good cooperation in maternal health is at risk, and some midwives are ranked in a lower wage class than others depending where they work.
What do you love most about being a midwife?
Being a midwife opened me up to a new world. I’m a guest in a special moment for a family.
I have been able to contribute to the successful initiation and continuation of breastfeeding. I’m with these women and their babies, and help give them the confidence they need to fulfil their breastfeeding success story.
Now I can share my experience and knowledge with colleagues during workshops, lectures and in my coaching role as national breastfeeding expert.
I still keep the lovely memories of attending births.
What progress is happening in your country, region, community or even just in your own professional life that excites you about the future of midwifery?
The profiling of the midwife remains necessary. As it is written in the Definition of a Midwife, we have to cover a lot of competencies and to show this to the world. Midwives are needed and need the respect they deserve. So we should work more with social media to talk about this beautiful profession, to share special moments together. We are proud that we have more researcher in clinical midwifery, more PhD’s.
We realise that midwives are needed to protect women from increasingly medicalised childbirth and prenatal care, so that future parents will be better informed about the policies in hospitals and the possibilities to protect normal birth. Thanks to the Mother Friendly guidelines in the BFHI project, we are seeing a positive shift in the labor ward. Mothers have the choice for their birthing partners and are getting better information if and when medical assistance is needed.
ICM is increasing its advocacy capacity for midwives at country, regional and global levels. As a member, what would you like to see ICM do to support advocacy efforts in your Association, community or country?
Living in Belgium, the visibility of midwives is important, as is the need for respect of this autonomous profession.