Advocacy, Association, Model of Practice, Philosophy, Research, Sustainability

Together Again: Day 2 Recap of the 33rd Triennial ICM Congress in Bali!

14 June 2023

After an exciting start to ICM’s first in-person Congress since 2017, the event continued on Tuesday with sessions and workshops that featured the resilience and tenacity of midwives, sparking discussions on how to strengthen and support midwifery globally. Here’s your daily ICM Congress 2023 recap for Tuesday 13 June! 

Plenary #2: The last healthcare professionals standing – an exploration of the role of midwives in humanitarian and fragile settings 

The plenary highlighted the crucial role of midwives and their associations in providing healthcare during emergencies. The session, moderated by Gordon Willcock, discussed the challenges faced by midwives in delivering sexual and reproductive health services amidst war, natural disasters, and fragile settings. 

Two very brave midwives working in conflict situations, Vira Tselyk from Ukraine and Jeffthanie Mathurin from Haiti resulted in standing ovations, as they each provided firsthand accounts of their work in crisis situations. Vira recounted caring for women in a bomb shelter during the war, revealing, “We had to save the lives of pregnant women and women in labour, and we had to go down to the bomb shelter. That was the worst experience in my 30 years of being a midwife.” Despite the immense challenges, Vira and her colleagues delivered 136 babies during their 42 days in the bomb shelter, sharing “When I heard those babies crying, it was louder than every shell for those days and the most powerful of songs. This cry was something that helped us stand up and keep doing what we were doing. It was the light of hope.” 

Jeffthanie Mathurin highlighted the powerful role of midwives in crisis, stating, “We are all heroes, always ready to give our all to save the lives of more women and babies, whatever the circumstances.” 

María Florencia Francisconi raised concerns about the neglected sexual and reproductive health and rights during humanitarian emergencies, emphasizing the importance of midwives in disaster preparedness and recovery. 

Dr. Natalia Kanem, Executive Director of the UNFPA, emphasized the bravery and dedication of midwives who risk everything to protect women in challenging circumstances. She stressed the need for urgent action to support and reward midwives, outlining five crucial steps including involving midwives in disaster planning, demanding better regulation and pay, investing in healthcare supply chains, enhancing safety and security measures, and increasing psychosocial support. 

Overall, the session underscored the indispensable contributions of midwives in providing essential healthcare and called for stronger and more resilient health systems with midwives at the forefront.  

Midwives for Impact: Showcasing Competent Midwives Saving Lives 

The Lancet Global Health published a significant study in December 2020, supported by UNFPA and ICM, highlighting the potential of investing in midwives to save millions of lives annually. The study focused on estimating deaths averted in low- and middle-income countries, emphasizing the role of well-educated and regulated midwives in reducing maternal deaths, newborn deaths, and stillbirths. 

In line with this, a session titled “Midwives for Impact” explores how partnerships and the global community can support the development of midwifery to decrease maternal and neonatal mortality. The session organized by Laerdal features discussions on recent studies, innovative solutions, and successful implementations through partnerships. 

Experts like Farida Begum from UNFPA Bangladesh highlight the role of midwives in humanitarian settings, while Fridah Temple from UNFPA Rwanda emphasizes the significance of investing in midwives to enhance the quality of care. Hiwot Wubshet, Country Director of Maternity Foundation in Ethiopia, shares the findings of a study on the Safe Delivery App, which provides instructional videos to improve healthcare workers’ knowledge and skills. 

Other panel discussions focus on the exceptional impact of competent midwives in saving lives, government-led initiatives, hands-on training, empowerment, and the need for scaling up and institutionalizing innovative solutions. 

These sessions shed light on the importance of midwives and the potential for their contributions to maternal and neonatal health outcomes worldwide.

How to use data and digital tools from the Global Midwives’ Hub to improve midwifery policies and services (Direct Relief & ICM) 

The ‘How to use data and digital tools from the Global Midwives’ Hub to improve midwifery policies and services’ session, organised by Direct Relief and ICM, explored the importance of data to help shape decision-making, frame effective advocacy, and guide evidence-based health programmes. For this to be achieved, data needs to be searchable, accessible, and connected to useful applications for analysis and visualization. 

The interactive session—facilitated by Jessica White, GIS program specialist at Direct Relief, and Mandy Forrester, Midwife Advisor at ICM—taught participants how to use the Global Midwives’ Hub (GMH) to discover data resources, make digital maps and dashboards, create analyses, and connect with midwives working to advocate for improved policies and health practices. The GMH is a tool that aims to improve midwifery policy and practice by assisting midwives’ associations throughout the world to deploy data more effectively. The GMH empowers midwives to become better advocates, collaborating partners, and healthcare providers. 

Jessica White highlighted how data can help advance the profession of midwifery and improve health outcomes, noting “Data has the power to drive insights, and insights have the power to drive action.”  

Decolonising Midwifery Education 

Researchers and indigenous midwives from Australia and the UK collaborated to advocate for the decolonization of midwifery education. The aim is to address challenges faced by Aboriginal students in completing their midwifery studies, such as ensuring cultural safety, cultural support, and clinical placements in Aboriginal communities. Embracing Indigenous knowledge alongside Western knowledge contributes to a more comprehensive approach to healthcare, known as “two-eyed seeing,” which promotes overlapping perspectives and culturally sensitive care. Decolonizing research and education empowers Indigenous communities by involving them as partners in the research process, leading to more meaningful outcomes. The Royal College of Midwives launched a toolkit and online hub on decolonizing midwifery education to challenge colonial perspectives and promote equity in healthcare. Increasing representation and promoting equity in the midwifery profession is crucial to reflect the communities served. “We must empower midwifery educators to challenge the implicit and explicit legacies of colonial perspectives in all aspects of midwifery education globally,” said speaker Heather Bower. 

Advocating for the Investment in Midwives’ Associations 

Midwives’ Associations play a crucial role in advocating for women’s rights, gender equality, and quality midwife-led maternity services. However, they face challenges in terms of organizational capacity, visibility, and credibility with governments and stakeholders. This hinders their access to funding and engagement in policy decision-making, leading to poor integration of midwives and midwifery services into health systems. Despite these challenges, Midwives’ Associations are innovating to increase their capacity and respond to humanitarian crises, even in complex contexts where governments or NGOs cannot reach. Experiences from Burundi, Ethiopia, Haiti, and Canada highlighted the importance of strong associations, financial sustainability, and strategic partnerships for improving maternal and infant health outcomes.

In this session, ICM Partners Bill & Melinda Gates Foundation, Direct Relief, Maternity Foundation, The White Ribbon Alliance, UNFPA Bangladesh, and UNFPA Global have renewed their commitment to investing in midwives’ associations in today’s ‘Advocating for the investment in Midwives’ Associations’ session at ICM Congress.
We look forward to having more partners join us to commit to recognising and investing in midwives’ associations as a solution to women’s health issues and as health coverage to the last mile, even during a crisis.

“It took ICM 98 years to get core funding; women’s health cannot wait, and must be prioritised, and it can begin with investing in MAs,” said Shree Mandke from ICM.

Using the new ICM education tools to strengthen midwife education workshop: going beyond the curriculum 

The 2021 State of the World Midwifery Report (SoWMy) emphasizes the importance of equipping midwives with the necessary skills and competencies to provide quality care and improving midwifery education in low and middle-income countries. In response, the International Confederation of Midwives (ICM) has developed six new tools to support schools in meeting the new Global Standards for Midwifery Education. These tools cover various aspects of midwifery education, including curriculum, competencies, assessment, clinical placement, and program design. Aligned with the WHO’s action plan, these tools offer educators resources to enhance midwifery education and can be used independently or as a package.  

“The world needs more than 1 million midwives, but we (only) have 10,000 midwifery schools. Many of them meet ICM Standards, but not all of them do,“ said ICM Education Midwife Erin Ryan, “Looking at data and talking to our MAs, we did a needs assessment, and came up with the biggest gaps we could identify.” 

The tools are available on the ICM website. 

Creating an enabling environment to provide abortion care workshop 

The workshop “Creating an enabling environment to provide abortion care,” organised by the Royal College of Obstetricians and Gynaecologists, equipped participants with essential knowledge and tools on the provision of safe, high-quality abortion services by midwives.  

Through engaging presentations and activities, facilitators Rumbidzai Sandra Zimudzi, Evangeline Dushimeyesu, Sangita Saha Prema, and Joy Kemp from the Making Abortion Safe programme opened a dialogue around the history of abortion provision, identified health cadres involved in care provision as recommended in the WHO Abortion Care Guidelines, and explored strategies to address barriers midwives face in providing safe, quality abortion care. 

By fostering collaboration and sharing key resources, attendees gained insights into how we can create a more supportive environment for midwives to provide abortion services, ultimately improving access to quality and safe abortion care. 


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