Established in September 2021, the Research Exchange Group on Midwifery and Maternal Health is a forum that connects midwives, doulas, researchers, community partners, clinicians, health system decision makers, pregnant people and their families, and all those with an interest midwifery and maternal health to discuss to research, policy and programming.

Group Conveners

• Dr. Ann Noseworthy, Retired Faculty, Memorial University School of Nursing and Retired Midwife, Association of Midwives of Newfoundland and Labrador
• Sarah Harnum, Registered Midwife, Central Health Regional Health Authority 

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Group Activities & Presentations

2024

November 1, 2024  at 12:30PM NT| Women’s Health Advocacy and the work of the Women’s Health Coalition | A discussion about women’s health advocacy and the work of the Women’s Health Coalition (WHC) with WHC Founder and President, Carmen Wyton.  The WHC  is committed to advancing a movement to speak openly, learn, and engage, to address barriers, gaps, and biases in menstrual, reproductive and sexual health. It envisions every woman is supported through all the ages and stages of their unique health experience and values choice, equity and credibility.  Its mandate is to be guided by patient experiences, informed by healthcare professional expertise, and enabled by partnerships, to advance evidence-informed recommendations to decision makers in government and health systems. 

November 29, 2024 at 12:30Pm NT | The progress of midwifery in Newfoundland and Labrador | The group will discuss recent  changes at the Association for Midwifery NL and at the College, the Innu Midwifery program, and progress with rolling out midwifery services in the province.

June 19, 2024 | An Analysis of the Mode of Delivery, Risk Factors, and Subgroups with High Caesarean Birth Rates Using the Robson Classification System |Caesarean Section (CS) rates are increasing worldwide, and the WHO recommends using the Robson Classification System to evaluate and monitor rates of C-Section. | Please join us as Visiting Professor (Division of Population Health and Applied Health Sciences, Faculty of Medicine, Memorial University), Dr. Gulpiya Uygar, presents the findings of her research, published in the Maternal and Child Health Journal, on Caesarean Section births in Northern Cyprus. This study was the first of its kind to use the Robson Classification System and revealed high CS rates in specific subgroups of the obstetric population. The research further found that inadequate and substandard data quality in the largest state hospital in Cyprus highlighted an urgent need for improvement in clinical practice.  The study laid the foundation for further nationwide studies to demonstrate the effectiveness of the Robson Classification System with specific recommendations provided to hospital management for improving the quality of the obstetric data and monitoring CS rates. The findings of this research could be a potential catalyst for comparative research in Newfoundland and Labrador and in other Canadian provinces and territories. Link to publication here.

 About the presenter:   Gülpiya Uygar completed her bachelor’s degree in Medicine from Xi’an Jiaotong University in China. After graduation, she worked for three years as a physician at the Disease Prevention and Control Center in Xinjiang Autonomous Region in Xinjiang, China. During this time, she worked at the No. 2 people’s hospital in Urumqi as a gynecologist and obstetrician for a year. She obtained Master's and Ph.D. degrees in Public health from the Faculty of Medicine at the National University of Malaysia (UKM)  while also working as a research officer at the United Nations University - International Institute for Global Health (UNU-IIGH). In 2016, she took a position at the Public Health Institute in Hacettepe University as a lecturer, and went on to become a Post-Doctoral Fellow at the Lee Kong Chian School of Medicine, Nanyang Technology University in Singapore. Returning to Turkey, she joined the Public Health Department of Ankara Yildirim Beyazit University as an Assistant Professor until and then in  2018, she began working at the Department of Public Health, Faculty of Medicine at Near East University where she is now Associate Professor. Her teaching and research interests are in the areas of Women’s and Child Health, Adolescents’ Sexual and Reproductive Health, Family Planning and Contraceptive Methods, Epidemiology, and Evidence-Based Medicine.

 June 7 2024 at 2:30PM NT | Ensuring the Safety and Quality of Maternity Care in Low-Resource Settings | This presentation by Drs. Jude Kornelsen and Kathrin Stoll of UBC used the framework of the Rural Birth Index developed in British Columbia and validated in Australia to consider the safety and efficacy of rural models of maternity care including those without local access to Caesarean Section, those with surgical access supported by Family Physicians with Enhanced Surgical Skills. The presenters explored primary and existing published data that considers population health outcomes in both settings and health system enablers that support optimal care, with a focus on facilitating rural midwifery models of care.

April 12, 2024 at 12:30PM NT| Trauma-Disrupting Care: Moving Beyond Trauma-Informed Care in Obstetrics |  Lisa Middleton, BHSc, MSW, RM, RSW, Social Work PhD(c) Carleton University  has been a practicing social worker in the Ottawa community over the past 16 years and a practicing Registered Midwife since 2015. Primarily working in the area of sexual and reproductive health, she has worked at numerous organizations at a community and national level. Working as a trauma therapist in sexual assault led her to become a midwife to help facilitate a safe-passage for people to give birth. Lisa often work with people who carry post-traumatic stress symptoms from previous births. People’s apprehension towards the end of the prenatal period brings up issues of fear and grief. The goal of her research is to create interventions that can lessen these trauma responses for future births.  Lisa's main area of academic interest is in perinatal mental health for both the birthing person and the family unit. More specifically, she is interested in promoting the healing of birth trauma for the birthing person. The focus of her Ph.D. research is on postpartum post-traumatic stress from childbirth.

Previous

September 29, 2023 | 1:30pm to 3:00pm | Experiences of Planned Unassisted Birth | Dr. Danielle MacDonald of Queen’s University discussed the findings from a recent systematic review that sought to identify, appraise, and synthesize the qualitative evidence on the experiences of women in high resource countries, with the aim of answering the following research question: what are the experiences of women who have planned unassisted home births?

Dr. Danielle Macdonald, RN, Ph.D., Assistant Professor, Faculty of Health Sciences, School of Nursing, Queen's University, is a researcher focused on understanding global birth and birthing care experiences. She is specifically interested in midwifery and nursing experiences, the experiences of birthing people and their families, and collaboration.

Resources:  Macdonald, Danielle; Helwig, Melissa Snelgrove-Clarke, Erna. Experiences of women who have planned unassisted home births in high-resource countries: a qualitative systematic review. JBI Evidence Synthesis 21(9):p 1732-1763, September 2023. | DOI: 10.11124/JBIES-22-00246

 Best Practice information Sheet: https://journals.lww.com/jbisrir/SiteAssets/Lists/HTMLContent/AllItems/BPIS%20Iss%209.pdf

 April 19, 2023 at 2:30pm- 4:00pm NT | Building Momentum for Perinatal Mental Health Research in NL with Dr. Archana Vidyasankar.  This meeting will provide an opportunity to develop research potential on perinatal mental health to inform both a provincial perinatal mental health task force and to align with strategic priorities of the Perinatal Mental Health Alliance.  At the meeting, we will uncover who is working in the area and discuss research in progress, work to develop collaborative potential/ teams; discuss data holdings and data required to inform perinatal mental health research; look at specific research themes, including, but not limited to: substance use, stepped care, newcomer/new Canadian mental health/access to care. 

Friday May 5 at 2PM Newfoundland Time |Perinatal outcomes of midwife-led care, stratified by medical risk: a retrospective cohort study from British Columbia (2008–2018) |Anecdotal evidence suggests that the profile of midwifery clients in British Columbia has changed over the past 20 years and that midwives are increasingly caring for clients with moderate to high medical risk.  Kathrin Stoll, Michelle Turner and Luba Butska conducted a retrospective cohort study that compared perinatal outcomes with a registered midwife as the most responsible provider (MRP) versus outcomes among clients with physicians as their MRP across medical risk strata. The researchers found that adjusted absolute and relative risks of adverse neonatal outcomes were consistently lower among those who chose midwifery care across medical risk strata, compared with clients who had a physician as MRP. Midwifery clients experienced higher rates of spontaneous vaginal births, vaginal births after cesarean delivery and breastfeeding initiation, and lower rates of cesarean deliveries and instrumental births, with no increase in adverse neonatal outcomes. They also observed an increased risk of oxytocin induction among high-risk birthers with a midwife versus an obstetrician as MRP.  Overall,  findings suggest that compared with other providers in BC, midwives provide safe primary care for clients with varied levels of medical risk. Future research might examine how different practice and remuneration models affect clinical outcomes, client and provider experiences, and costs to the health care system. Kathrin Stoll has degrees in psychology and sociology, and recently completed an interdisciplinary PhD (midwifery/nursing/epidemiology) at the University of British Columbia. She has been active in academic and community based research for the past 10 years, with a focus on maternity care issues. She is co-editor of the Canadian Journal of Midwifery Research & Practice and is a part time lecturer in the European Master’s of Midwifery program. Luba Butska, RM, PhD, Assistant Professor of Teaching, Midwifery Program, University of British Columbia | Luba is an Assistant Professor of teaching at the University of British Columbia, and has been a registered midwife since 2007. Luba has had the good fortune to collaborate with Kathrin Stoll PhD to publish and present work nationally and internationally about midwifery in British Columbia, most recently  “Perinatal outcomes of midwife-led care, stratified by medical risk: a retrospective cohort study from British Columbia 2008-2018.”  Michelle Turner | RM, MA, MFA, PhD Student at UBC | Michelle Turner (she/her) is a writer, educator and midwife in B.C. with an MA in drama and MFA in creative writing. She works as clinical assistant professor at the University of British Columbia where she teaches clinical skills, anatomy and physiology to bourgeoning midwifery students.

January 27, 2023 |1:00PM- 2:30PM Newfoundland Island Time | An institutional ethnography of the social organization of labor and delivery nurses’ fetal health surveillance work| Despite evidence-based guidelines recommending the use of intermittent auscultation during women’s low-risk labors, nurses often use continuous electronic monitoring to assess fetal heart rate during the intrapartum period, regardless of women’s risk levels. Paula Kelly completed her doctoral research in January 2022 to explore this issue. The purpose of this research was to gain insight into nurses’ work by examining how nurses carry out fetal health surveillance; particularly how and why nurses choose to use continuous electronic fetal monitoring. Paula’s presentation will include background to the study, methods, findings, and concluding remarks.  About our presenter: Paula Kelly is an Assistant Professor at Memorial University of Newfoundland Faculty of Nursing. She has a rich nursing career in women's health and obstetrical care. Her program of research focuses on the social organization of healthcare, nursing knowledge, and nurses’ work. Research Publication: Kelly, P., Quance, M., Snow, N., & Porr, C. (2022). Using institutional ethnography to explicate the everyday realities of nurses' work in labor and delivery. Global Qualitative Nursing Research, 9, 23333936221137576. https://doi.org/10.1177/23333936221137576

March 10 at 3:00pm NT | Canadian Panel on Midwifery | a group of midwives and midwifery resesrchers from across Canada wil provide an overview of midwifery services in Canada.

 October 18, 2022 |  A discussion about the state of midwifery in Atlantic Canada.  In this panel discussion, we looked at midwifery in Atlantic Canada: past, present, and future:  PearI Herbert, retired midwife provided the history of midwifery in NL; Thea Penashue of the Innu Roundtable Secretariat, updated the group on the Innu Midwifery Project; Vanessa Webb, a nurse midwife in Nain outlined the status of Inuit  midwifery practice in Nunatsiavut; Sarah Harnum, Chair of the College of Midwives of NL, provided insights on the regulatory issues and barriers midwives face in NL and an update on the status of midwifery in Central Health; Brianna Thompson talked about her role as Chief Midwife for Newfoundland and Labrador; Ann Noseworthy spoke about the Association of Midwives of NL; Brittany Stairs of MANB (Midwives Assoc of NB) gave an update on midwifery in New Brunswick; Joyce England, President of the PEI Midwives’ Association told us about midwifery on Prince Edward Island; Jessica MacDonald of the Association of Nova Scotia Midwives spoke about midwifery in Nova Scotia.

 NOTES FROM OCT 2022 ATLANTIC MIDWIFERY PANEL

December 2, 2022 at 3:30pm: Cecilia Benoit, University of Victoria : The Regulatory Amalgamation for Nursing and Midwifery in British Columbia: Benefits & Challenges.

January 21, 2022 at 1:00pm NST | Martha Traverso-Yepez, PhD (Universidad Complutense, Madrid) Honorary Research Professor, Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland | Dr. Traverso-Yepez will discuss research related to maternal health.  Her past projects include a study entitled: Engaging Mothers to Make Mental Health a Critical Item in Primary Health Care Assessment and The effectiveness of wraparound supports for young mothers experiencing at risk environments.

February 25, 2022 at 1:00pm NST | Dr. Cristina Mattison, Assistant Professor (Part-Time), Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Adjunct Scientist, Obstetrics and Gynecology, McMaster University is a reseacher in the areas of fertility and maternal health.

March 18, 2022 at 1:00pm NST | The Newfoundland and Labrador Context for Obstetrics Services: A Focus Group Discussion| Researchers at NLCAHR's Contextualized Health Research Synthesis Program (CHRSP) are working on an Evidence in Context report on the use of Patient Decision Aids in decision-making during the childbearing year. The team has already gathered and synthesized the scientific evidence— all they need to do now is to place that evidence in context for Newfoundland and Labrador – to support relevant local decision making. This is where you, as a member of our Research Exchange Group on Midwifery and Maternal Health, will come in! Please join us for an important conversation with CHRSP Research Officers Colin Walsh and Christie Warren as we explore key themes iin obstetrics service delivery.

March 25, 2022 at 1:00PM NST | The Innu Midwifery Project:Restoring Midwifery and Community Birth Thea Penashue, Gisela Becker, June Fry, Kathleen Cranfield
This presentation will tell the progress made to reintroduce midwifery to Sheshatshiu and Natuashish in Labrador, drawing on Innu Elders’ knowledge of Innu birthing practices, to support the training of Innu midwives using a culturally specific, hands-on, and individually paced learning approach. We will describe how restoring midwifery to the Innu communities would result in Innu babies being born into Innu hands on Innu lands, fostering a greater connection to the land and culture, continuation of cultural practices and culturally safe care, and empowering women in the context of their childbearing experience. About our presenters: Thea Penashue is the Health Manager with the Innu Round Table Secretariat (IRT). Thea is also the Co-chair of the IRT Midwifery Steering Committee and advocates for the return of midwifery to the Innu communities of Labrador. She lives with her husband and two daughters in North West River, Labrador. Thea gave birth to her second daughter in a traditional Innu tent. Gisela Becker is a registered midwife and midwifery consultant with the Innu Round Table Secretariat in Labrador, and Chief Advisor for midwifery implementation with the Government of Prince Edward Island. Gisela is a past president of the Canadian Association of Midwives from 2009 to 2010 and represented Canadian midwifery at the International Confederation of Midwives Council in 2008 in Glasgow, Scotland, and 2011 in Durban, South Africa. Gisela held the position of the first Alberta Health Services Director of Midwifery Services and is a former Assistant Professor in the Midwifery Education Program at Mount Royal University in Calgary, Alberta. Gisela was the Provincial Chief Midwife with the Government of Newfoundland and Labrador from 2017 to 2020 and became the first registered midwife under the NL Health Profession Act. Gisela has many years of experience working in Indigenous and northern communities and a strong interest in research, data collection and program evaluation. June Fry is a BN, RN and in her 38th year of her nursing career. June has worked in a variety of positions from a staff nurse, Public Health Nurse, Head Nurse, Regional Nurse to Director of Nursing, Coordinating Instructor in Licensed Nursing programs, curriculum development for the Integrated Nursing Access Program for the Inuit of Labrador, Maternal Child Health Nurse with Health Canada, and the last 6 years working with the Innu Round Table Secretariat in Labrador, as the Innu Child Health Coordinator. June truly has loved all her nursing career positions, all came with their challenges and great satisfaction. June received the Excellence of Nursing Award in 2010 from First Nations and Inuit Health Branch for her work with the two Innu communities in Labrador. Kathleen Cranfield is a registered midwife in Fort Smith, NWT and a midwifery consultant with the Innu Round Table Secretariat in Labrador. Kathleen has been instrumental in bringing regulated midwifery services to the Yukon.

April 29, 2022 at 1:00PM NT | Dr. Lisa Morgan, University of Ottawa | Experience of Reproductive Healthcare f| With a goal to improve service provision, this study examined the experiences of women in Northern Ontario with respect to their uptake of reproductive healthcare services. As part of this mixed methods study, women in Northern Ontario completed a survey, offered in English and French, about their reproductive healthcare experiences, and a portion of participants were also interviewed. A multimodal recruitment strategy and maximum variation sampling was applied, with a goal of collecting the experiences of a diverse group of women. Analysis was based on 173 completed surveys and 19 semi-structured qualitative interviews. The interview data is grouped under five conceptual constructs, with “gender” as an overarching construct, found to be a factor in the remaining four: the characteristics of good care; the relationship with the provider; the care environment, and administrative practices. Additionally, respondents felt that midwives excelled at providing quality reproductive healthcare and would favour increased access to midwives for reproductive health care throughout their lives. Most survey participants rated their reproductive healthcare experiences as fair to good overall but indicate room for improvement in the relationships with their providers and administrative support. Women residing rurally, without a family physician, and lower socioeconomic statuses are statistically more likely to prefer a midwife for reproductive healthcare. The survey results indicate a preference for female healthcare providers by the majority of interviewees. Changes driven by strong health policy may be required to engage women in recommended reproductive healthcare more fully. Although northern geography will always present challenges that may not be subject to amelioration, other factors preventing women from accessing care are more amenable to change, and as argued here, this is a right of women and an obligation on the part of governments to provide equitable access for all Canadians to healthcare services.

September 17, 2021 at 1:00pm NST | Introductory Meeting

October 15, 2021 at 1:00pm NST | Perinatal Mental Health with Dr. Archana Vidyasankar |In Newfoundland and Labrador, we have one of the highest rates in Canada of anxiety and depression in pregnancy and postpartum and this has motivated psychiatrist Dr. Archana Vidyasankar to create change. She, along with other passionate individuals, helped initiate the Perinatal Mental Health Alliance of Newfoundland and Labrador to gather community groups, healthcare providers, interested parties, government, educators and many more amazing, like-minded people to help support our young families. Dr. Vidyasankar enjoys creating awareness and providing education for medical students, residents, physicians in various disciplines on this topic.

November 19, 2021 at 1:00pm NST | Health Before Conception: Research on Fertility & Exercise with Dr. Katie Wadden| During the past three decades, rates of obesity have tripled for women of childbearing age in Newfoundland and Labrador. Unfortunately, women with obesity are three times more likely to experience infertility than women with a normal BMI. For patients with an elevated BMI who are experiencing infertility, weight loss is the first-line recommended therapeutic intervention as it has been shown to have a positive impact on fertility outcomes. However, fertility physicians and nurses have minimal time and resources to evaluate the potentially modifiable risk factors (e.g., diet and physical inactivity) that are associated with obesity. Dr. Wadden’s research program in reproductive health started in direct response to the growing number of patients with obesity and infertility, combined with a gap in healthcare services to support them. Since 2017, her research team has been building partnerships between relevant stakeholders, including women’s health clinicians, patients of the fertility clinic, allied health professionals, and experts from the fields of exercise physiology, endocrinology, clinical epidemiology, health promotion, and exercise psychology. Findings from the work that has been completed by Dr. Wadden and her team with the fertility and exercise group will help to develop innovative interventional research that targets cardiometabolic health before conception. About our presenter: Dr. Katie Wadden is a CIHR post-doctoral fellow in the Faculty of Medicine at Memorial University of Newfoundland. Katie completed her Ph.D. in Rehabilitation Sciences at the University of British Columbia. Over the past several years, academically and professionally, Katie has dedicated her efforts to advocating for the inclusion of Kinesiology in healthcare. In 2017, a fertility physician from the NL Fertility Clinic approached her to develop an exercise program for patients with obesity and infertility. Since this request, Katie has completed an immersive dive into the study of preconception and reproductive health. Her current interests are in cardiorespiratory and metabolic biomarkers related to reproductive health and the psychosocial experiences of women with infertility and obesity.

December 17, 2021 at 1:00pm NST | Presentation TBA