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

Together Again: Day 3 Recap of the 33rd Triennial ICM Congress in Bali! 

ICM
14 June 2023

It’s time for your final daily ICM Congress recap! The Congress brought our global community of midwives together again to build relationships, cultivate ideas, identify pathways for progress, and bring evidence into reality. 

If you haven’t already seen our Day 1 and Day 2 recaps, be sure to check them out. See you in Lisbon in 2026!

 

Plenary #3: The next 100 years of ICM and midwifery – strategies for ensuring greater support, inclusivity and representation for our global community of midwives 

Moderated by Dr. Sally Pairman, Chief Executive of ICM, this plenary explored the role of ICM in advancing inclusive midwifery and how can we support midwives to deliver the best-possible care to women and all community members. The global leaders featured on this panel discussed strategies for ensuring the next generation of midwives reflects our increasingly diverse communities, as well as practices midwives can adopt to ensure they’re providing inclusive care. The session uplifted the delegates’ integral role in building a resilient, inclusive ICM and midwifery workforce, while continuing to uphold and promote the midwife-led model of care. 

Karel Williams, a First Nations midwife and Director of the Rhodanthe Lipsett Indigenous Midwifery Trust in Australia, spoke to the impact of systemic racism in the healthcare system on Aboriginal midwives. She outlined the government’s attempts to eradicate Aboriginal people, the impacts of structural violence, and how health systems remain colonial, Western constructs that continue to harm Indigenous people. “The maternal mortality rate for First Nations women is 3x that of other women and the neonatal mortality rate for First Nations babies is 2x that of other babies,” Karel shared, highlighting the disparity of health outcomes faced by Indigenous people seeking sexual and reproductive health services. 

Karel challenged ICM in its failure to represent Indigenous midwives and centre their voices in conversations around decolonisation. “First Nations midwives have voices. We are the experts in our own lives,” she said, “Nothing for us, or about us, without us.” 

Dr. Kaveri Mayra, Postdoctoral Fellow at the University of British Columbia, discussed her work using arts-based research and body mapping to understand the experiences of women who have given birth and faced obstetric violence in India. 

She then turned to organisations in the Global North, powerfully stating, “I am sick and tired of everyone who is trying to share my voice and my people’s voice on these platforms because you do not know what to do when a midwife is amplified.” Dr. Mayra explicitly called upon the ICM to “help us lift the shoe from our necks so we can help lift the shoe from the necks of the women we are supposed to take care of.” 

Dr. Anshu Banerjee, Director for the Department of Maternal, Newborn, Child and Adolescent Health and Ageing at WHO, focused on the importance elevating diverse midwife leadership in decision-making processes and of using data to address equity and inclusion. “If we don’t know where women are dying, where our health workforce is, where our midwives are, where the gaps are, it’s going to be very difficult to address this issue and get the right midwives at the table,” he said. 

Ana Barreto, Director of the National Birth Equity Collaborative and Founder of Black Women Policy Lab, spoke on systemic oppression and how those with power must understand and deconstruct the harmful systems they benefit from, stating, “Listening is not enough. Human rights is not a favour.” She further emphasized that “our work is to break the barriers between who is viewed as a human and who is not.” 

The panel challenged ICM to transform harmful power structures by directly representing traditional midwives and others on the margins, advocating for funding to support Indigenous midwives, and expanding the scope of midwifery to be inclusive. ICM was called to monitor progress on these actions to share at the next Triennial Congress in Portugal.

Workshop: ICM Membership Benefits 

During this workshop, delegates learned about the revised membership benefits offered by ICM, how to fully utilise these benefits and address common challenges within their midwives’ associations through an exploration of case studies.  

Facilitators Justine Laurent, ICM Membership & Operations Coordinator, and Rebecca Dahl, ICM Communications Lead, taught participants how to identify specific membership benefits that address the unique needs of their MAs, so as to enhance the practice, education, and regulation of midwifery in their respective countries and worldwide. Participants shared the challenges they were facing and suggestions for how to further improve the membership benefits. 

Concurrent Session: Skills for maternity emergencies 

This session featured four speakers who presented valuable insights on improving obstetric care and emergency skills in remote and challenging regions. 

Jody Lori emphasized the significance of obstetric triage in reducing delays during childbirth and discussed strategies aimed at enhancing obstetric triage systems to improve maternal and neonatal outcomes. 

Rachel Campbell highlighted the importance of assessing the effectiveness of emergency obstetric care education and training programs in challenging regions. She may have discussed the challenges faced in delivering emergency care and proposed potential solutions to enhance outcomes. 

Margaret Mina discussed an emergency skills program specifically designed for remote midwifery settings. The emphasis was likely on innovative approaches and adaptations necessary to provide effective emergency care in areas with limited resources, ultimately empowering midwives to handle obstetric emergencies. 

Satellite Symposium: Midwifery Misfits 

This satellite symposium challenged the exclusionary and alienating—yet all-to-common—question “Are you a midwife though?!” The session, chaired by Kaveri Mayra, explored inclusion for midwives on the margins through potential evolution of the definition of midwives and midwifery. 

The panel of misfits included Bahareh Goodarzi, Edythe Mangindin, Harriet Nayiga, and Franka Cadée, who are midwives born and educated in Uganda, Iran and India, in courses that do not align with global midwifery standards, as well as members of marginalized communities educated in line with the global standards of midwifery in Netherlands, UK, America and Iceland. 

After opening the floor to participants to share their own experiences, the panellists encouraged all misfits to share their stories through a global survey, with an aim to create new discourses and find solidarity. 

Workshop: Midwifery Regulation 

The ICM Global Standards for Midwifery Regulation (2011) can guide amendments to existing legislation and promote changes that strengthen regulatory frameworks to support autonomous midwifery practice. Legislation, policies, and procedures based on these standards will create midwifery regulatory frameworks that protect mothers and babies through the provision of safe and competent midwifery care. 

In countries with limited or non-existent regulatory processes, these standards can guide the development of new midwifery regulation. Countries with existing midwifery regulation can use these standards as a benchmark for future changes. 

Presenters reiterated the importance of regulation, since evidence shows that fully educated, licensed, and integrated midwives, supported by interdisciplinary teams and an enabling environment, can deliver about 90% of essential SRMNAH interventions across the life course. 

Many Midwives’ Associations are located in countries which have incomplete or no form of midwifery regulation. This includes those countries where midwifery regulation is collectively managed with another profession such as nursing, making regulation unclear and confusing. 

Initiating and maintaining midwifery regulation is not straightforward and midwifery regulation is facing challenges globally, including those to midwives’ autonomy and definition of scope of practice. 

Partner Funded Session: WHO infection prevention and control global strategy: what does this mean for midwives and midwifery leaders? 

This World Health Organization (WHO)-led session focused on mobilising action to improve infection prevention and control globally, with a specific emphasis on maternity care. The session highlighted key messages from the new global strategy for infection prevention and control, strategies and resources for preventing infection in maternity care and lessons on implementation from the field. The session shared how measurable improvements can be achieved to reduce the risk of healthcare-associated infections in women and babies 

The discussion emphasised the need for effective infection prevention and control programs to protect women and their babies from healthcare-associated infections, as many countries currently face high levels of infection and sepsis, which contribute to a significant number of deaths among women and infants. However, an increasing number of countries are committed to strengthening infection prevention and control, particularly in maternal and newborn care.

Plenary #4: PUSH @ Bali: Addressing the world’s most pressing issues through midwifery

Moderated by the founder of Every Mother Counts, Christy Turlington, our final plenary session brought together midwives from around the world who, through their everyday work and activism, exemplify the potential of the midwifery scope of practice to extend far beyond pregnancy and childbirth. 

The panel featured Ibu Robin Lim, Filipina-American-Micronesian midwife and founder of Yayasan Bumi Sehat, Neha Mankani, PUSH South East Asia Regional Coordinator, and Dr. Nikia Grayson, Chief Clinical Officer at CHOICES Center for Reproductive Health. The midwife panellists drew upon examples from their own careers to discuss the various ways they provide support to their communities and the advocacy initiatives they’ve led and engaged in over the years to improve community wellbeing and the status and recognition of midwives and midwifery. 

The session energised our audience of midwives and midwife advocates around their scope of practice and its hyper-relevance in addressing our world’s most pressing issues.

Closing Ceremony

During the Closing Ceremony, Franka Cadee, the outgoing ICM president, delivered a powerful farewell address. She urged the audience to “move #midwifery forward together,” emphasizing the progress that has already been made in the field. The new board members were also announced, marking a new era of leadership for ICM. Excitement filled the air as the date and location for the next congress were unveiled – Lisbon 2026.