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Dondero Lecture - Anti-oppression in Midwifery Research and Practice

Saraswathi Vedam

Speaker Bio
Dr. Saraswathi Vedam is Lead Investigator of the Birth Place Lab and Professor of Midwifery in the Faculty of Medicine at University of British Columbia. Over the past 37 years, she has served as clinician, educator, researcher, and mother of four daughters. Dr. Vedam has coordinated several transdisciplinary and community-led research projects across North America, including the Access and Integration Maternity care Mapping (AIMM) Study on the impact of integration of midwives on maternal-newborn outcomes, and the Giving Voice to Mothers Study that established significant differences by race, type of provider, and place of birth in experience of mistreatment by maternity providers. She is currently PI for RESPCCT, a national study to examine respectful maternity care across Canada, with a focus on amplifying voices of communities that are seldom heard. Dr. Vedam and her team developed and validated three new person-centered measures, the Mothers’s Autonomy in Decision Making (MADM) scale, the Mothers on Respect (MOR) index, and the Mistreatment by Providers (MIST) index. In 2017 MADM and MORi received the National Quality Forum Innovation Prize, and they are now are being applied in 23 countries to evaluate quality of maternity care at the institutional, system, and country levels. Professor Vedam has been active in setting international policy on place of birth, midwifery education and regulation, and inter-professional collaboration. She convened 4 national transdisciplinary Birth Summits in the US, and chaired the 5th International Normal Labour and Birth Research conference in Vancouver. In 2017, she was named Michael Smith Health Research Institute Health Professional Investigator.

Course Description 
What does the evidence tell us about the effects of oppression, loss of bodily autonomy, and discrimination during health care encounters on short- and long-term well-being? Does type of provider affect experiences of reproductive and perinatal services? Should caesarean reduction be the goal? Do Black and Indigenous lives matter to midwifery and medical providers? What do service users say? How do providers action their beliefs about human rights?

This session will explore findings and insights from participatory research on quality, safety, risk, and present anti-racist actions, models, and accountability tools that clinicians and health systems can adopt to accept responsibility and enhance quality and safety.

This session will share findings from our participatory action research projects, that examined the lived experience of perinatal services in North America through an equity lens. We convened a multi-stakeholder team and co-developed an online, cross-sectional survey that assesses health care adherence to and violations of respectful care. We included indicators across twelve domains of respect, disrespect, and mistreatment, including items that measure autonomy and mistreatment during provider interactions, health systems factors, and the impact of type of caregiver and place of birth. More than 10,000 people including service users from multiple identities, circumstances and backgrounds, described supportive, exceptional care as well as discrimination, disrespect and/or mistreatment during pregnancy and/or childbirth. Descriptive quantitative and qualitative analyses show lower MADM and MOR scores among non-dominant populations, and in hospitals; more respectful care by community-based midwives; inconsistent health system responsiveness to meet needs for reliable information and services.

CEUs Offered: 1.5 CE

Course Expiration: October 13, 2024