18 Saraswathi Vedam KEYNOTE
Channel: Virtual Midwives
Date: 2020-05-05

VIDM 2020 :: The Midwifery Mandate in Global Crises: Leadership, Innovation, and Humility

The World Health Organization (WHO) and Office of High Commissioner of Human Rights have affirmed that freedom from discrimination, harm and mistreatment are human rights and important outcomes (Bohren et al., 2015), and[i] that health systems need to improve measurement and accountability for the experience of childbearing care (Freedman and Kruk). Loss of autonomy, mistreatment, abuse, coercion, and disrespect during pregnancy and facility-based birth before and during the COVID-19 pandemic have been documented by researchers, clinicians, lawyers, governments, and community organizations. Poor treatment due to institutional racism, implicit bias, and lack of access to preferred models of care, can transform health care encounters into human rights violations.  Among families with non-dominant identities, circumstances, or backgrounds, asymmetric and hierarchical power relationships, as well as gender-based violence, these health inequities are exacerbated.

Integration of midwives into health care systems is a key strategy that can improve quality of care (Lancet 2014).  Overall, in high, middle, and low resource settings, those who experienced midwifery care report lower interventions, more respect, and greater autonomy in decision making; but experiences of discrimination and disrespect are still significantly increased among marginalized communities, regardless of type of provider or birth setting.  Indigenous midwifery traditions, and strengths-based community-led rapid response to adverse environments can offer innovative solutions to all midwives.

What is our responsibility as midwives to model self-reflection, leadership, adaptability, collaboration, and accountability for improving equity, access, and respect during reproductive health encounters?  This session will describe emerging research findings on the prevalence and characteristics of respectful maternity care, midwifery strategic leadership, and transdisciplinary initiatives to address the gaps in respectful care for all families – during global crises and beyond.


RESOURCES:
Birth Place Lab: https://www.birthplacelab.org/ 

Presentation slides available at vidm.org