Midwifery Today Conference
“Promoting Midwifery: Skills from Around the World”
Byron Bay, Australia • 4–9 November 2014
Conference Classes

Tuesday • 4 November 2014 • Pre-Conference

9:00 am – 5:00 pm
Choose one full-day class: A1 or A2
A1
The Anthropology of Reproduction: Childbirth, Midwifery and the New Reproductive Technologies
Robbie Davis-Floyd

A whole college course in a day! This workshop offers an overview of the exciting sub-discipline of the anthropology of reproduction from its early beginnings to its latest findings. We will concentrate on anthropological studies in four major areas: childbirth, midwifery, the new reproductive technologies, and the politics of reproduction. Robbie will describe the works she considers to be key in each area and summarize their findings, and will suggest important directions for future research. Her goal is to provide a stimulating overview of these anthropological sub-disciplines for midwives and others who want to know what the social scientists are up to, and to accompany that overview with an extensive annotated bibliography that will provide a helpful template for further exploration and research.


A2
Shoulder Dystocia and “Malpresentations” — A two-part class
Tine Greve and Gail Hart
Part 1 — Shoulder Dystocia

Our teachers discuss the mechanical and physical causes of shoulder dystocia; the associated risk factors; symptoms and signs to predict it; and tools to remedy it. They will analyze tools and methods used to overcome panic reactions and demonstrate effective treatments. Learn about new methods, new mnemonics, and the latest research!

Part 2 — “Malpresentations”

This is an in-depth look at malpresentations and mal-rotations; their likelihood and causes; palpation methods to identify them; and the techniques for assessing and dealing with them. You will learn many tips for helping these errant babes to move into better position for vaginal birth. Bring your techniques to add to this body of midwifery knowledge!

Wednesday • 5 November 2014 • Pre-Conference

9:00 am – 5:00 pm
Choose one full-day class: B1–B4
B1
Midwifery Issues and Skills, Part 1 (You do not need to sign up for Part 2.)
Tine Greve, Gail Hart, Angelina Martinez Miranda and Sister MorningStar

These classes are designed to improve and enhance your midwifery skills and knowledge. This is a great workshop for both experienced and newer midwives.

9:00 am – 10:00 am
VBAC: Completing the Circle
Sister MorningStar

Help create beautiful experiences for these families.

10:10 am – 11:10 am
Freedom from Fear
Angelina Martinez Miranda

Fear in pregnancy and birth can have many consequences for both the family and health care provider. This class will help you define, understand and move through the fear that confronts us. Learn several ways of helping women, including midwives and doulas, turn fear into trust.

11:10 am – 12:10 pm
Emotional Issues in Labor
Sister MorningStar

This session will help the caregiver understand the effect that emotions may have in the outcome of labor. We will learn about predictable stress points in labor and offer concrete suggestions that can be used to improve the birthing woman’s ability to handle labor.

1:30 pm – 2:30 pm
Clinical Issues in Labor
Gail Hart

This will be an overview of issues and complications with insights on how to prevent them and what to do if they occur.

2:40 pm – 4:00 pm
Intuition and Protocol: Where Do the Two Meet?
Sister MorningStar

Midwives have used intuition to make decisions for years. In this workshop, we will discuss techniques for developing your intuition and guidelines for knowing when to consult, refer or transport.

4:00 pm – 5:00 pm
Establishing Early Breastfeeding
Tine Greve

Breastfeeding is an essential part of mothering. Explore evidence-based prevention of problems. When problems arise, mother and baby need a lot of encouragement. Learn the fundamentals along with the political initiatives that have helped to re-instill “breast is best.”


B2
Spinning Babies — Sorry; this class is full.
Gail Tully

Learn to spot a long labor before labor begins and turn it around to a shorter labor. This course goes beyond Optimal Fetal Positioning with the 3 Principles of Spinning Babies: Balance, Gravity and Movement in pregnancy and in labor. Compare anterior and posterior fetal position. Practice labor progress techniques appropriate to the level of descent and tell whether a cesarean is needed or just more time. Fewer cesareans/fewer transports may be possible now. “When I took Gail’s class I knew we had to have this amazing teacher join us in Midwifery Today conferences.”—Jan Tritten.


B3
Emergency Management of Breech Birth
Sue Cookson, Carol Gautschi and Angelina Martinez Miranda

We will begin this day-long workshop with a discussion of how to detect, prevent and turn breech babies. But what to do when attempts at turning fail, and the mother decides to go forward with a vaginal birth? Or when the midwife is surprised with an unexpected breech? The knowledge of breech birth is an essential midwifery skill. Although intentional breech birth is not for beginners, everyone is welcome in this class because every birth attendant must know how to handle the unexpected breech birth. Various methods and techniques will be discussed and demonstrated including the use of waterbirth for breech birth

9:00 am – 10:00 am
Preventing Breech Birth
Sue Cookson, Carol Gautschi and Angelina Martinez Miranda

We will have a Tricks of the Trade type of discussion where we talk about ways to safely turn or prevent breech babies.

10:10 am – 11:10 am
Introduction to Breech
Sue Cookson

We will discuss how to identify the signs of a safe breech vs. signs of dystocia, and how to determine when it is too late for transport. The benefits of upright breech, ways of resolving breech shoulder dystocia, and managing head entrapment will be presented. Does “hands-off-the-breech” really mean us? Videos and photos will help illustrate techniques.

11:15 am – 11:45 am
The Absolute Necessity of Knowing Breech as a Midwife
Carol Gautschi

Although breech birth is not for beginners, you never know when one will surprise you.

1:00 pm – 2:15 pm
Difficulties and How-to’s of Safely Handling Breech
Sue Cookson and Carol Gautschi

We will cover palpation skills, estimating fetal weight, amniotic fluid, and how to communicate with the baby through touch and words. We will cover basic skills including the hands-off approach and how to handle problems while staying calm. Frank, footling and complete breech will be discussed, as well as cord prolapse, fetal heart tones and recognizing intrauterine growth restriction (IUGR) and other complications of breech presentation.

2:20 pm – 4:30 pm
Breech Roundtables
Sue Cookson, Carol Gautschi and Angelina Martinez Miranda

These intimate roundtables give the participant a chance to dialog with each teacher individually. Learn what factors may lead to breech presentation and when external version is contraindicated. Our speakers will discuss the mechanisms of normal and stuck breech birth and techniques for handling each.

4:30 pm – 5:00 pm
Wrap Up, Questions and Breech Birth Stories
All teachers

B4
9:00 am – 5:00 pm
Two half-day classes (You must sign up for both.)
9:00 am – 12:30 pm
Postpartum Recovery—Placenta and the Parents
Jodi Selander

The postpartum period can be a difficult transition for some women and their partners. Learn how expectations can affect outcomes, and how to work with couples to mitigate their expectations. Discuss the hormonal components that impact postnatal mood disorders, and how the placenta may be helpful in alleviating some risk factors for the development of those mood disorders, such as postpartum depression. We will discuss current theories behind how placentophagy may be beneficial to postpartum recovery, as well as the latest scientific research behind the practice. You will gain a greater understanding of how to help your clients have a better postpartum recovery, both physically and emotionally. Jodi has been working in this field for nearly 10 years and is now conducting research which she will present.

2:00 pm – 5:00 pm
The Power of Touch and Tenderness
Jenny Blyth and Fiona Hallinan

Through experiencing the power of touch and tenderness, you can understand the beneficial effect on the pregnant and labouring woman. Learn to use your touch respectfully, tenderly and effectively to bring a woman into her body, help prepare her for birth, to connect with her, to negotiate her birth, and ultimately teach her to care for herself. This experiential workshop will cover working with a woman’s pelvis, respectful connection, communication and negotiating, and much more. This workshop will be experiential. Wear soft, comfy clothing (no jeans).

5:15 pm – 6:20 pm
Open to all registrants
Christian Midwives Meeting
Carol Gautschi and Eneyda Spradlin-Ramos

All are welcome.

Thursday •6 November 2014 • Pre-Conference

9:00 am – 5:00 pm
Choose one full-day class: C1–C4
C1
Midwifery Issues and Skills, Part 2 (You do not need Part 1 to take this class)
Sue Cookson, Robbie Davis-Floyd, Carol Gautschi, Sister MorningStar and Eneyda Spradlin-Ramos

These classes are designed to improve and enhance your midwifery skills and knowledge. This is a great workshop for both experienced and newer midwives.

9:00 am – 10:25 am
Initial Interview and Prenatal Care for Well-being
Carol Gautschi

Learn how to evaluate and nurture the emotional, physical and psychological well-being of pregnant women. Learn about nutrition and the art of care and how that affects the birth. Learn important elements of the first visit.

10:35 am – 12:00 pm
Twin Birth
Sue Cookson

Sue has extensive experience with twin birth. Though in some countries midwives do not generally attend twins, it is normal practice in others. Dealing with twins is an important skill for all midwives because they may come as surprise, or a woman may decline cesarean. Sue will discuss strategies for safe vaginal twin birth, including positioning, time of delivery, and issues with premature delivery as well as avoiding postpartum hemorrhage.

1:30 pm – 2:30 pm
Counseling for Positive Outcomes
Sister MorningStar

In this session we will explore how various counseling modalities such as visualization, affirmations and couples’ dialogue can assist us to make the most of the time we spend with families. We will also explore the power of words and how negative words do influence outcomes.

2:45 pm – 4:30 pm
The Trouble with Homebirth Emergencies
Robbie Davis-Floyd

What Davis-Floyd has called “fractured articulations” often result during home-to-hospital transport, in which the worlds and worldviews of homebirth midwives and their clients collide with the hospital world and its dominant, technocratic worldview.

4:30 pm – 5:00 pm
Trusting Yourself to Trust Birth
Eneyda Spradlin-Ramos

Learn ideas for how we can develop the trust necessary to allow the patient unfolding of the birth process, while remaining alert and prepared for any problems or complications.


C2
Mexican Traditions and Techniques
Angelina Martinez Miranda

The observation of cultural traditions and their impact on pregnancy and birth is fascinating. Angelina will discuss positioning, remedies, techniques and customs from Mexico. The origin of these techniques and traditions goes back thousands of years. We will learn how to use a rebozo, a very useful tool in all parts of the childbearing cycle for preventing and dealing with complications. Discover simple techniques that promote healthy pregnancy and birth. This course will add greatly to your knowledge. You will actually practice what you are learning under Angelina’s watchful guidance.


C3
Preserving Normal First and Second Stage and How to Handle Difficulties
Tine Greve and Gail Hart

Learn how individual care and good communication can positively affect labor. Our teachers will share the protocols and techniques they use to help the mother move through labor. This evidence-based discussion will include prolonged rupture of membranes, failure to progress, abnormal labor patterns, monitoring methods, non-medical intervention and more. Listen to these experienced midwives discuss constructive and effective ways to handle both normal and complex situations, correct problems, support the woman who has difficulties, and the best methods to assess progress. Bring your questions and experiences in what promises to be an exciting day!


C4
9:00 am – 5:00 pm
Two half-day classes (You must sign up for both.)
9:00 am – 12:30 pm
Amazing Space—Realizing Anatomical Potential in Birth
Jenny Blyth and Fiona Hallinan

Help each woman activate her true anatomical potential through a deeper understanding of the nature of her soft tissue connections within her pelvis. Learn about relaxed yet highly effective ways to enhance that amazing pelvic space through mobilizing the sacrum, “splooshing,” pelvic alignment, and exploration and preparation of the vaginal space and soft tissues. Simple techniques can help a woman through birth, whether the labor is straightforward or involves posterior, compound presentation or deep transverse arrest. This workshop will be part presentation and part experiential. Wear soft, comfy clothing (no jeans).

2:00 pm – 5:00 pm
Undisturbing Birth
Sarah Buckley

Sarah presents her ground-breaking material on the hormonal physiology of childbearing, including the ecstatic hormones of labor and birth and the hour after birth. There will be opportunities for discussion and small group activity to apply the principles to professional practice or personal experience.

Evening
General session
Drumming on the Beach
Maha Al Musa

(time and details to be announced)

Friday • 7 November 2014 • Conference Day One

9:00 am – 10:10 am
Opening general session
Promoting Midwifery: Skills from Around the World
Sarah Buckley, Gail Hart, Angelina Martinez Miranda, Sister MorningStar, Rachel Reed and Jan Tritten

It is imperative that midwives be well-educated, know physiologic birth and be skilled in dealing with complications. Our hands and heart skills are an essential part of this wisdom, and have been cultivated in local midwifery knowledge around the world. Retaining these skills in balance with new technology and understanding of the diversity of cultures is the essence of being “with woman.” This panel of midwives will share the discoveries of their regions and explore deep issues in the art and science of midwifery.

10:10 am – 11:30 am
General session
Birth Models That Work: Standing the Test of Time?
Lesley Barclay and Robbie Davis-Floyd

Much social science and midwifery literature heavily critiques the obstetrical treatment of birth. Taking a more positive and constructive approach, this presentation describes what co-editors Robbie Davis-Floyd of the US, Lesley Barclay of Australia, Betty-Anne Davis of Canada, and Jan Tritten of the US call “birth models that work”—a phrase we used as the title of our 2009 book. In the soon-to-be-published second book we are working on, we intend to include models of both education and practice. This talk first presents the criteria we have developed to identify and characterize “birth models that work” and then presents a number of optimal birth models from countries as diverse as Canada, the US, the UK, the Netherlands, Australia, New Zealand, Japan, Mexico, Brazil, the Philippines, and Samoa. How have these models stood the test of time?

11:30 am – 1:00 pm
General session
Film at Lunchtime

Grab a quick lunch, then come watch the film!

Film: A World of Birthworkers
Jenny Blyth

Mother in India, Gloria in Canada, Cristina in Mexico, Amina in Turkey, Chongnaiy in Cambodia, Evelyn in Barbados, Ester Pop in Guatemala, Thao Sy & Nang Khamdy, Mai Dao & Nan Seng in Laos… How did these people come to attend births? Was it through dreams, lineage, ambition or circumstance? What has been challenging for them? What do they love about their work? How do they pass on their knowledge?

This film is an honoring and celebration of traditional and autonomous birthworkers around the world—as they are, as they have been, and as they will continue to be….

1:00 pm – 2:30 pm
Choose one: D1–D4
D1
Beyond Captivity: Birth Intelligence, Not Intellect
Sister MorningStar

There is an innate intelligence that guides and protects the complex unfolding of Birth. In captivity something of that intelligence is lost. Bring your questions and experience and together we will discover how to realign with the fierce intelligence, beyond the intellect, that seeks to protect the body, mind and soul of motherbaby in any setting, any circumstance or any culture. We plan to rediscover the secrets of nature that bring birth and long-term well-being to motherbaby. Birth is the beginning of everything else.

D2
Promoting Optimal Fetal Positioning
Gail Tully

What can be done at pregnancy visits by midwives and doulas to help women and couples to be proactive in childbirth preparation with fetal positioning? Let Gail Tully, “the Spinning Babies Lady,” introduce you to the First Principle of Spinning Babies: Balance. Try out three techniques that you can then teach pregnant women and couples over three prenatal visits. Please bring massage tables if you have any available.

D3
Nuchal Cords, “Prolonged” Rupture of Membranes (PROM) and Meconium-stained Fluid
Rachel Reed

In this session we will focus on three common birth variations. The physiology and current research relating to each variation will be discussed. Midwifery practice will be explored, including minimizing risks, and identifying and managing complications.

D4
Pain, Pain, Pain; Risk, Risk, Risk
Gail Hart

Childbirth does not need to be a painful experience. Much of the pain in childbirth is caused by fear and anxiety. Fear increases tension, which increases pain, which increases fear. Midwives and doulas can use methods to reduce fear and tension in order to reduce pain. Most women can be relatively comfortable throughout labor if they have tools for relaxation, support and confidence.

2:45 pm – 4:15 pm
Choose one: E1–E4
E1
The Impact of Birth on Lifelong Well-being — Sorry; this class is full.
Sarah Buckley

We will look at birth from broad perspectives, including evolutionary, hormonal and microbiological, with a focus on the benefits of normal, natural, physiologic birth for mothers and babies. Sarah details the hormonal physiology of labor and birth and also the importance of gut flora transfer from mother to baby for lifelong immune and brain function.

E2
Creating Viable Midwifery Systems in the Developing World
Lesley Barclay

From Lesley’s in-depth understanding of how various models work, she will help us understand elements necessary for creating good care systems in any culture.

E3
Prolonged Pregnancy: Waiting, Watching, Worrying
Gail Hart

What to do when the due date comes and goes? What are the real risks of prolonged pregnancy? How do we assess for signs of postmaturity syndrome? How do we know when it is time to intervene, and how do we intervene when it’s needed? Let’s look at what the evidence says about risks and how to mitigate them, discuss how to monitor the prolonged pregnancy, and learn how to balance protocols with common sense. Also covered will be how to calculate due dates as accurately as possible, and how to determine fetal well-being.

E4
The Tipping Point: Making Room for Asynclitism
Gail Tully

“What’s that you want me to do?” Baby’s head is tipped as if listening for advice. “I’m a bit stuck.” Understand the role of the pelvic floor in asynclitism and learn about a technique to make room for the head to come down. Wear comfortable stretch or yoga pants to try the technique with a friend. Bring a massage table if you are local and have one, please.

4:30 pm – 6:15 pm
General session
Mexican Midwifery
Angelina Martinez Miranda

The midwives in Mexico have developed their midwifery over the millennia with techniques that work for various birth issues. Angelina gives us an overview of the many interesting and useful ways Mexican midwives have developed to help women in pregnancy, birth and the postpartum period.

Saturday • 8 November 2014 • Conference Day Two

9:00 am – 10:30 am
General session
Birth as a Rite of Passage and the Midwife as a Ritual Companion
Rachel Reed

This session is based on Rachel’s PhD thesis, “Midwifery Practice during Birth: Rites of Passage and Rites of Protection.” We will explore the concept of the midwife as a ritual companion during the childbirth rite of passage and the implications for midwifery practice. We will discuss practical ways in which midwives can facilitate women’s rite of passage and promote conditions for empowerment.

10:30 am – 12:00 noon
General session
The Impact of Interventions on the Hormones of Birth
Sarah Buckley

Sarah will explore the impact of major maternity-care interventions on the hormonal physiology of birth, including epidurals, cesareans and induction. Sarah also reviews the hormonal physiology of labor and birth and its benefits for mother and baby.

1:30 pm – 3:00 pm
Choose one: F1–F4
F1
Techniques for Controlling and Preventing Hemorrhage
Gail Hart

Many episodes of excessive blood loss are either preventable or controllable without medication. It is important to understand the full process of third stage and to facilitate the delivery of the placenta correctly. Can active third stage management still be supported as the wider body of evidence accumulates? Let’s look at the evidence and learn about techniques used where routine oxytocics are not accessible and which render the need for pharmaceuticals rare. You will learn about how to assess third stage and deal with complications to reduce the risk of excess blood loss.

F2
Massage for the Childbearing Year
Angelina Martinez Miranda and Eneyda Spradlin-Ramos

Our teachers will explain why massage is essential for pregnant and birthing women and show practical application. They will discuss the importance of healing touch as a preventative tool and safe remedy for the pregnant, laboring and postpartum woman. Come join this class where time for hands-on practice will be provided and guided.

F3
Daughter of Time: The Postmodern Midwife
Robbie Davis-Floyd

Recognizing the limitations and strengths of the biomedical system and of her own system, the postmodern midwife moves fluidly between the two to serve the women she attends. She is a shape-shifter—she knows how to work to change the medical system while appearing to comply with it. She is a bridge-builder, making alliances with biomedicine where possible and building connections between traditional and professional midwives. When possible she attends conferences and meetings, making connections with other midwives in other parts of the world, increasing her ability to translate between systems, and gaining consciousness of midwifery as a global movement.

F4
Nature Birth
Jenny Blyth

Some women, by accident or design, give birth outside the conventions and walls of home and hospital, mostly without dramatic incident. When this happens, it throws into question the endless debates about the safety of certain environments, who is qualified to attend, and how influential or essential the presence of the experts is over the power of birth. How can you prepare or be prepared for such an event? Let’s share our most memorable and outrageous stories of births in Nature.

3:30 pm – 5:00 pm
General session
International Issues
Robbie Davis-Floyd, Eneyda Spradlin-Ramos and Jan Tritten

Brainstorm with us and your peers on how we can effect changes in midwifery and childbirth on the global level. We can make changes for the better with knowledge of global possibilities. We will share techniques, systems and political and educational ideas that will help you further the midwifery model in your sphere of influence. A discussion of the Global Midwifery Council, the Birth Revolution and the International Alliance of Midwives will be included.

5:00 pm – 6:00 pm
General session
Organic Midwifery
Carol Gautschi

It is time for a redefining of terms in regard to midwifery. As present-day "midwifery" is incorporating more and more of an impersonal, medicalized mentality, midwives must rise up and reclaim the organic, life-infused roots of motherbaby care, returning to the old ways without discounting the new, and preserving the distinction between the art of midwifery and the field of medicine.

8:00 pm – 10:00 pm
General session
Cabaret
Robbie Davis-Floyd and Tine Greve, Mistresses of Ceremonies

Open to all registrants: The cabaret is for everyone to show their many talents whether in song, dance or whatever you do that you would like to share. The cabaret is really fun! Maha Al Musa will lead us in learning the fundamentals of belly dancing.

Sunday • 9 November 2014 • Conference Day Three

9:00 am – 10:15 am
General session
Tricks of the Trade
Eneyda Spradlin-Ramos, Jan Tritten, Gail Tully and You

Share the techniques you’ve perfected in your practice or bring your burning questions to this roundtable of pertinent tips on a wide variety of topics. Previous sessions have included facilitating effective contractions, dealing with prolonged labor, preventing perineal tears, helping the slow-to-start baby and holistic first aid. This is always a much-appreciated session, for its sense of sisterhood as well as its information. “Worth at least two weeks of academic training,” said one participant.

10:30 am – 12:00 pm
Choose one: G1–G4
G1
The First Hour after Birth
Gail Hart

Gail will share her brilliant insights and findings on the hormonal states of mother and baby and the interaction that occurs. She will cover how we can facilitate the process without disturbing motherbaby. Gail’s teaching on this subject makes it a fascinating class. Her insights can help you improve your practice.

G2
Uncommon Complications
Carol Gautschi

Learn about how to be prepared for “anything and everything”! Birth stories will be used to illustrate assessment techniques, problem solving and ways in which practitioners can build their self-confidence in dealing with various emergency and unusual situations. You will learn about how to be more prepared for uncommon complications that you may encounter: unusual bleeding, thrombocytopenia, meconium, neonatal jaundice, hematoma formation, signs of embolism and more. Learn about how to manage these while keeping the family and yourself calm. Bring questions and cases to study.

G3
Sex in Pregnancy and Childbirth
Eneyda Spradlin-Ramos and Jan Tritten

This is often the neglected talk in prenatal care. Learn to help your clients by straightforward discussions. Also learn how undisturbed birth is inherently sexual in nature and how even our well-intended assistance can interfere. Share sexy birth stories and come away with new ideas of how to promote transformation in a couple’s sexuality and pleasure in birth.

G4
Think, Observe and Challenge What We Were Taught
Sister MorningStar

“Why is this procedure necessary?” The two most dangerous answers are, “That’s the way I was taught,” and “That’s the way I’ve always done it.” Come learn to look at your midwifery practice with an open mind, learning from the women. It’s time to rewrite the textbooks.

1:30 pm – 3:30 pm
Choose one: H1–H4
H1
Prolonged Labor
Gail Hart

How do we get a long labor to progress? Long labors may be associated with complications ranging from social or emotional issues to physical problems. We will learn different reasons for prolonged labor, as well as methods for helping women move along in labor. Learn about methods to help detect the pathological labor from the simple prolonged labor. Analysis of myth and reality will also be discussed.

H2
Waterbirth
Carol Gautschi

Carol will explore the many benefits and ways of using water in birth and will discuss its unique properties—psychological as well as physical. Waterbirth is not only an option for a woman to give birth undisturbed and in dignity, but it has medical advantages for mother and child. Breech births, OP births and twin births benefit from waterbirth. Breech waterbirth needs no hands, no extra warming for the newborn’s body or other interventions. The ease of attending births in water is a joy.

H3
Tradition and Profession: A Blend That Works
Angelina Martinez Miranda and Sister MorningStar

This session will focus on bringing our traditions into the modern world. Our teachers draw upon a rich tapestry of birth in traditional cultures, blending it with what has been learned from midwives. The panel strives to come up with the best possible blend, always considering each woman unique. Their great love of that process is sure to kindle our passion for birth.

H4
Shoulder Dystocia
Gail Tully

Gail will explain and discuss the physiological causes of shoulder dystocia. She will describe symptoms and signs of five types of dystocia in three levels of the pelvis. The FlipFLOP memory tool is introduced to reduce panic reactions. See how recent research supports physiological resolution of shoulder dystocia with rotation and bringing out the posterior arm. Come practice this important skill.

3:40 pm – 5:00 pm
Closing general session
Changing Birth Worldwide
Carol Gautschi, Angelina Martinez Miranda, Sister MorningStar, Eneyda Spradlin-Ramos and Jan Tritten

Even as more evidence mounts showing the harm caused by unnecessary obstetrical interventions, such interventions continue to increase and cesarean rates around the world continue to soar, causing trauma to mothers and babies. How can midwives, doulas and mothers help bring needed change to others? Learn what you can do in your community to promote positive birth change. We are all needed—let’s hone our skills at creating optimal birth models for the women of the world!