GOLD Learning Labour & Delivery Online Symposium 2024

Up to 30% of women experience severe back pain in labour. In qualitative studies women have described how labour back pain limited their mobility and altered their plans for analgesia use. Injections of small amounts of sterile water into the skin of the lower back are used to alleviate back pain for up to two hours. Whilst much research supports the effectiveness of the technique, critics suggest a placebo effect or dismiss the procedure as ‘midwifery voodoo’. This presentation will examine the causes and physiology of back pain in labour, examine and critique the research into sterile water injections, and describe the various techniques, benefits and limitations for use in clinical practice. Finally, I will discuss strategies for and dealing with barriers to implementation.

The language of resiliency, wellness, and burnout is commonplace today, as the healthcare system looks to address the state of the nursing profession since the Covid-19 pandemic. But what are the solutions that actually work? How do we find our way to not just survive, but to feel inspired by the future of our role as nurses? We can find answers in the practical applications of polyvagal theory, systems thinking, and returning to the heart of perinatal nursing. We also learn that birth outcomes improve along the way.

Acupressure is an ancient Chinese technique based on the principle of acupuncture, which involves the use of finger pressure (without a needle) on acupuncture points situated on the meridians. Applying pressure to these acupressure points will increase the production of oxytocin, also known as the love hormone, and endorphins. This is important during labour as it aids relaxation and reduces the perception of pain. Acupressure is a non-invasive technique. It is an accessible, effective and safe birthing tool for midwives and support people and promotes partner involvement. As it is drug free, it does not have harmful teratogenic effects, thus providing a much safer and satisfying childbirth experience. In addition to this, it is proven that touch during labour enhances the childbirth experience in as much as it reduces pain. By facilitating physiological births it also reduces the need for epidurals and C sections.

Promoting these skills and using acupressure techniques during labour enables professionals to offer women a wider range of choice in how to manage pain relief. Therefore, the use of acupressure offers a positive and non-traumatic birthing experience, provides a more general sense of wellbeing, empowers women and strengthens relationships with the midwife and the support people.

Vitamin K deficiency bleeding in newborns, a problem of the past, has been thrust into the spotlight due to myths spread on social media. In this session with Dr. Rebecca Dekker of Evidence Based Birth, we will unravel common reasons for refusing the Vitamin K shot, including fears of the “Black Box Warning” and beliefs that the injection is synthetic, toxic, unsafe, or unnatural. You’ll walk away with an in-depth understanding of the newest research on Vitamin K, including evidence on oral drops vs. the shot, and the benefits and risks of each. Don’t miss this chance to strengthen your knowledge of Vitamin K for newborns so that you can have more informed conversations with your coworkers and clients!

Modern medicine seems to have made so many advances in so many areas… yet far too many birthers still experience birth-related injuries or are left with unwanted symptoms after birth, like incontinence and pelvic organ prolapse. Good news: biomechanics may not be the be-all-end-all, but their consideration definitely has benefits. In this presentation, you’ll have the opportunity to really get to know the pelvis, and learn how to help birthers choose and use different positions at different times throughout labour. As an added bonus, you’ll also learn how to promote pelvic floor wellness in a birthing person.

It is thought that hypermobile Ehlers Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD) are not rare, and yet they are rarely diagnosed. As these conditions affect connective tissue throughout the body they can have a profound impact upon those childbearing, where the human body goes through a multitude of changes in response to pregnancy and birth. They can also impact on the newborn. In order to provide guidance where currently there is none, an international group of patients and academic and clinical experts came together to co-create evidence-based international guidelines for the management of these conditions in pregnancy, birth and beyond. Guidelines include the antenatal, intrapartum, and postnatal periods, and touch on a range of evidence in this field. The lived experiences of those childbearing with hEDS/HSD also demonstrate how clinicians can make a real difference to outcomes and experiences, yet clinicians often express a need for more knowledge and education in this area. It is hoped that these guidelines will be used by clinicians and birthing people to facilitate evidence-based decision making in this area for improved outcomes and experiences overall.

Fundal, or uterine, assessment is routinely performed by nurses, midwives, and medical providers as a standard of care in the immediate recovery period after birth and postpartum. There is a long history of community based birth attendants providing fundal assessment for early identification, prevention, and intervention of complications that involve or impact the uterus. This continues in current U.S. and global medical, midwifery, and nursing standards of care. Fundal assessment, or “checks” have also been increasingly described as severely painful, traumatic, and/or as a form of obstetric violence by clients. An evidence based, trauma informed approach to fundal checks protects and promotes safety for both the client and the provider of care. In this session we will examine and enhance existing understanding of fundal assessment, trauma informed care to reduce the potential for client harm/trauma and/or provider secondary trauma.

When pregnancy is medically complex, the focus of care generally becomes the pathology of the complication. But the physiology of labor remains the same. By supporting the normal physiology of labor and birth, even when medical surveillance and intervention are indicated, care providers can support autonomy, reduce trauma, provide for healthy bonding, and improve outcomes.

This presentation will look at specific examples and case planning to highlight the opportunities for building physiological birth care into the medically complex birth scenario.

Preeclampsia remains a significant challenge in maternal healthcare, demanding careful attention and informed approaches during labour and birth. Drawing from a wealth of practical knowledge and research, this presentation navigates the complexities of preeclampsia management, emphasizing the importance of timely, evidence-based interventions, patient-centred care, and collaborative teamwork. By distilling key findings and best practices, this presentation aims to empower healthcare professionals with the knowledge and tools necessary to optimize clinical management and improve outcomes for mothers and infants affected by preeclampsia during labour and birth. It also aims to empower women and their families with information on what to expect and to enhance their advocacy efforts, especially in low- and middle-income countries.

Since the beginning of recorded birth experiences, babies have been placed in their mother's arms immediately after birth. At the turn of the 20th century, hospital births began to become the norm, and "sterile" procedures removed the immediacy of this critical juncture. What does 21st century hospital birth hold in this post-pandemic healthcare environment? ? How do we promote, protect and enhance the birth experience in Labor and Delivery to support bonding and breastfeeding?