 Without, let's get to the topic of today. I'd like to introduce Marie. She'll give us more details about her and Marie will be talking to us about connection in midway free, a student midwives perspective. So welcome, Marie. Marie is from Scotland. So welcome, Marie. Let me just hand over the presentation back to you. Welcome. Thank you, Stella. That was absolutely wonderful. I'm going to just close my public chat. So if anybody has any questions, you can put it in the chat and Stella will keep an eye on them for me as we go along. Okay. So welcome to my talk this evening. We're here to talk about connection midway free and I'm a student midwife. So here I am. And I thought I would give you a wee bit of background about myself and where we are today and and the current course. So my first degree was postgrad was in environmental science and heritage conservation, which will, I'm using partially for this talk as well. And I came to Scotland for my postgrad. And that's in Andrews. And I went on to manage multidisciplinary teams on large historic estates here in Scotland. And then 13 years ago, I had my first child. And after connecting with Sheila Kitzinger, who was a wonderful, wonderful person within midwifery gave so much to us. And I became a fertility teacher, perinatal therapist and birth companion and the families I supported covered for NHS boards. And I did that independently. The new course that I'm mentioning here. So we've got new standards of proficiency within the new course. We are regulated by the Nursing and Midwifery Council. And this new course has started at RGU this year, of which I'm a second year now, currently. We this new course encompasses case loading and continuity of care, a case loading and more preparation for prescribing and eventually finishing with a post postgrad that we would do separately. And the newborn infant examination, which traditionally was a postgrad and was used to be done by solely by pediatricians and is now encompassed within the course. And so I've got a couple of references here. And I will have references at the end, which will will flash up quicker than you will be able to read. And I know this. However, also know that this is recorded. And if you want to check out the references, you'll be able to go back onto the website and then pause and you'll be able to see what I've referred to. And so hide the mushroom. Well, let's get comfortable. And I'll explain. But before I do, I'm going to recognize that your midwives, student midwives and researchers here today in the main, I'm absolutely thrilled that you've all come to connect this evening. And from far and wide by the looks of things in Canada and New Zealand and Germany, UK and Tix and K-Cos, I'm so thrilled to be here with you tonight. Or in the morning or in the afternoon depends on where you are, I guess. So what ground will we cover tonight? I'm going to talk about autonomy into subjectivity, some organizational psychology, ergonomics, polyvagal theory, mycological theory as well for good measure. And I want to note that I take confidentiality very, very seriously. And so what I do share tonight in the case loads is anonymized. My families that I care for are always my priority. We're all born. Most of us will have been born with the support of a midwife and that unites us all as humans. So what on earth is this? I can imagine your thinking. So this is a slide to introduce the analogy of midwifery being likened to mycological macrocosm and microcosm. And here we have got, I'll introduce you to Eurospora Crassa who is here under fluorescence microscopy. And really this was a piece of work which I won't go into in any depth but I thought it was really interesting and inspiring. And because it actually showed how the connections worked between wild and mutant variety. And I thought that was interesting because we're talking about connections. So let's see what I see as the midwifery microcosm. So that's here. So you can see if you remember I mentioned the little mushroom at the beginning there. Here's the student midwife and she or he is a mushroom here on the forest floor. And underneath them is a 3D network and you can see represented not every not everybody's here but you can see as we go around. We've got third sector support ancillary support and the medical support and specialist clinics and teams, additional professions, our governance and regulators and professional associations and unions. And we've got our academic midwifery support underneath us and clinical midwifery support as well. And we've also go and try protection and support professionals to that we incorporate. And what I wanted to get across with this slide was the student midwife is what you see on the on the surface underneath there is a vast 3D network that's ever changing it's in dynamic equilibrium which is why it wouldn't ever be possible to actually put everybody's title. And that and organization on this slide because it's always changing. And it's symbiotic as well. In fact, when I mentioned to my son, and who's now 13, and that I was doing this talk, and I run it through with him. I asked him is there anything that you'd like me to say. And what he said was, and remember that all of the, and when it comes to the mushrooms that they use the network to reduce me each other. And he's right. We do, don't we, as professionals and micro and the mushrooms actually the fungal network underneath actually pushes across the forest and information and nutrients and shares in a symbiotic way. And so that's how we support each other and symbiosis and and how do we connect. Well, we connect using lots of different. Again, everything will be here. And, but we've got conferences and invited guests either into an interest boards and or within universities. We've got clinical record systems so the confidential confidential structures, such as bad Jeanette and and we've also got journals and research. We all know some wonderful journals and research papers that we can and think of that connect our ideas together. We have got professional panels and boards and you can you can get involved in workshops and review boards and to help work out guidance and and we've also got group training and that that can be so helpful to bring all the teams together. And shorts rounds. Those are when we have lots of different professionals come together to share various different stories and can be quite inspiring. And we've got all said and linked in which are ways of sharing our knowledge with each other of what we've achieved and how we're linked. And obviously we've got handovers and within the clinical practice social media. And at my university RGU we had and we continue to have an international students project and where the students came together with other universities and the other I did it was with Switzerland and we produced a conference together, which was wonderful and I still maintain friendships from that today. And we also have terrors, which is an online learning system, which is used by NHS Scotland and all the universities link into that and island, which is a wonderful learning system that's online and run by our union RCM. And here at the end, we've got something called SBAR and closing the communication loop because I think that's quite important. And SBAR is is a way of the professionals putting information across about the people that we are taking care of in a succinct manner, and it stands for situation background assessment and recommendations. And that enables us to be better communicators and closing the communication loop means that if somebody asks somebody to do something, they close it back around again and say, yes, I understand. And then I have done it. Great, you've done it. There's basically the simplified version, but that it that that by using those techniques, we actually avoid making mistakes within the clinical practice. So I thought I would share a couple of anonymized scenarios that happened and that they talk about this. So I was involved when a what we call a maternal collapse case and a woman collapsed in her bed postnatally. And I went over I pulled the cord and the emergency cord which pulled which informs the team to come running and flattened the bed and started to do ABCDE, which is a way breathing circulation. It's another way of as a protocol that we would follow medically. And then the team arrived, which was greatly relieved about afterwards. The important thing I want to get across with that that case study was that afterwards I spoke to the senior obstetrician and asked some questions. And because I did that, I gained some knowledge and skills that otherwise I wouldn't have had. And I am so grateful to have for having these relationships. Also, the senior charge midwife took the time and got me a cup of coffee, which is a wonderful moment of connection to. And, yeah, I was I learned a lot from that scenario. PPH stands for postpartum hemorrhage. A woman had had her baby and she was bleeding heavily. So I worked with a supervisor and had prompt team come and respond to the call that we made with the emergency bill. And everybody fell into place and we stabilized her and we transferred via ambulance to a bigger hospital. And I went on to stay with the woman for a lot longer and to help her feel safe having somebody that she knew and and that was worthwhile for her. Many departments were involved in that case and keeping her safe. And it was like it was like being involved in a well oiled machine. Everybody fell into place. Everybody knew their part and actually I was really proud to be part of that. So this slide is talking about protective connection. So human factors and ergonomics for those of you might might not have come across that before. Basically, I would summarize it as having the right person in the right place at the right time with the right resources. That can make such a big difference to how we connect and how well and streamlined our services work. Recently, we've had, I would be remiss if I didn't mention this very important report, the Occenden report, which looked into failings within maternity services. And it was found that working relationships and resources and really needed improving in maternity services. And I think that by improving ergonomics and human factors, we can actually work towards doing that. Having good boundaries and understanding that the woman has a choice and her choices are paramount. Her informed choices, it's up to us as professionals to inform her and then she and support her choice. And that is protected via legislation and guidelines. And so I've referenced a few here underneath. So now we're going to talk about the microcosm. A little bit about intersubjectivity. So what I'm calling the microcosm is you can see here with this diagram that I've done a complicated Venn diagram. And here's the midwife. And then we've got the mother and the baby with them. And then the wider family, so the partner and children. So what I mean by intersubjectivity is the conscious and unconscious sharing of ideas between two subjects. And so the subject's been being here at these various circles. And that's based on Hursel's theory, which I've linked there below. And it's this, obviously we would like this area, this kind of, this is the intersubjectivity area here. And it changes. So this would be moving further out if we didn't have a great connection as a student midwife and midwife with the family. Or perhaps we did things that actually brought these two closer together. And sometimes there are moments when the baby is out here as well. For example, in cases when the mother's unwell and you need to look after the baby separately. And she's not there to do skin to skin. So you're interacting directly with the baby alone. And yeah, so that's what I'm sharing by putting this here. What I would like to say about it is that really what we're trying to do within midwifery is we're trying to bring those closer together overlapping so that we are and I'm going to use a bit of polyvagal theory here. And again, that's referenced below that. So where we are aiming to have glimmers and by glimmers and what I mean is times of connection, calm clarity, curiosity, rest recovery. These are the things we want to promote. And as opposed to triggers, which is shock and crisis disorientation and disassociation and fight, fight and freeze. So anything that we can do to bring these closer together in this microcosm as student midwives and midwives is great. We humanize birth in that way, working collaboratively rather than having an implied embodied authority over the women. We're working together as a team. And of course, like I say, they move. The other one that I would like to I'd like to mention here as well is motor peeps work, which is wonderful work that shows that relaxation sessions and can help bring the intersubjectivity together from my point of view closer together because the women and the midwife and the baby are much calmer. And there is a joint understanding. So I think that's important work that I'm looking forward to hearing more about and this further work published with them. So with that in mind, and I wanted to do a week caseload comparison and the here we've got three types of women and each with different needs. And we have the lady at the top. She had quite complex social needs, a very unusual style, which could be very easily and be misunderstood and regression. She really needed dim lights, no necessary noise and no touching. And because I was her continuity of carer and student midwife, I was able to facilitate that and make sure that everybody who was supervising me and was able to know before they went in the room. And she had a wonderful outcome. And then there's the second case load and lady and she had a really complex medical history. She was very, very well informed and she really needed to feel fully heard about her choices. And she took great comfort in doing research and so I could support her in that. And she really appreciated humor not everybody appreciates appreciates humor in the clinical setting. But she really did. And because of that, again, I approached her care totally differently. And then there was the third case who this lady had post traumatic stress disorder. And she really needed me to help slow things down with my voice. She needed a warm, nurturing voice. She needed to be touched. She needed regular eye contact. And then afterwards, she said, you believed I could. So I believed I could. And that's really what we're aiming for, isn't it? That shared connection. So I thought I would share those with you. And of course, there's the baby. So we're also connecting with the baby. When we're doing. We're using our hands to find the position of. Can you hear me now? Okay, thank you. And we're connecting with the baby. And when we're doing abdominal palpation with our hands, we're feeling for position and we're also feeling for any fetal movement. And when we are using the fetus scope, the Doppler or the CTG, we're connecting with the baby in the baby's health and listening to the heartbeat. And we're also connecting with the baby when we do the newborn infant exam. So I often change what order I would do things in according to how the baby is cooperating or not. And you are connecting with that baby and doing that. And then here I wanted that you might wonder why on earth has she got some musical score here. And it's because when I was learning newborn recess, and I realized that when I was doing inflation breaths, I needed to slow down. So I don't know whether or not you know the blue Danube at all. It's a very slow walls. It's a well known walls. You might know it from Space Odyssey or Squid Games. And it's that one that goes. It's like that. So you can imagine when you're doing the, I can't see what my camera is, when you're doing inflation breaths, it's one, two, three, two, two, three. And so I use that in my mind. And so now every time I'm doing that thereafter, I think of this lovely walls. And so that when I was actually in a newborn resuscitation situation, I was actually kept calm. Because I was thinking about this walls. And that was enabling me to remember. And by using the resuscitation protocol, we're communicating with the baby, communicating with the baby to tell them to breathe. We want them to breathe. So we're on the last slide here. So here are my wonderful, wonderful peers at RGU in Scotland. This was actually, I got their permission to share this photo. I am immensely proud of all of them. This was actually the first time that we came together because of the blended learning that was partially online and partially with only the skills being face to face. And those skills and sessions were done in small clusters in order to protect everyone against COVID-19. And this was this year. And this photo was taken. And it was actually the first time that our entire cohort were together. So you might think in those circumstances, how on earth are you connecting as a cohort? Because obviously in the past cohorts would come together as students and you would see each other day to day during theory slots. And presumably you're not doing that. We've actually connected quite well. We have formed some wonderful relationships. We've also, because of the blended learning and being online, it's been really invaluable because it's enabled those of us who live in rural areas to continue. If we're far away from uni, maybe we've got caring responsibilities at home. It's actually been absolutely wonderful to have that. And I hope it continues for people because it really makes Midwifery more accessible to people in the whole of Scotland. The Midwifery Society of which I'm the president of, that brings people together too. The student midwives come together. We've organised talks such as sign language and rheumatherapy. We've had nights out at the ball. We had a spring ball recently, which I'll say a bit more about in a bit. And we've had invited speakers and we've done some reasonable amount of fundraising as well through exercise. So we fundraised over £2,000 for charities that supports families in the UK and abroad. And you might be wondering, what on earth is Leather and Bozies Murray? Well, it's Doric, which is a local dialect where the university is based. And it basically means a chat or a talk and a cuddle. And those are online sessions. Those online sessions are done regularly so people can drop in no matter where they are on placement. And bear in mind that our placements are covering a location. If you think about the map of Scotland and you get draw a line across the top of the central belt including five and a wee bit to the west. And then our placements cover all the way to the top of Orkney north of that. So it's a vast, vast area. And we've got younger and old students going out into various different places out on placement as well as those in theory. And everybody can pop in to the Leather and Bozies. So it's a bit like a coffee meeting really. And it has a set format. So everybody comes in, you would introduce yourself with your name, what area you're in. And something good that's happened recently. So we hear some real wonderful victories and something that's a be in your bonnet. Now that could be maybe something didn't go too well or something's not going your way. Or it could even, we've had a few that an article has come out and we're feeling kind of cross about that. And we took it all out and we support each other. And we supported each other through health and financial emergencies and grief. And we've had some amazing highs. And I am immensely proud of my peers. I really am. And now I also wanted to talk about the bore, which happened after the deadline for the slides. And otherwise I would have shared some wonderful pictures of our spring bore. And we actually had, it was, it was a beautiful evening. And we all came together in our lovely, our lovely dresses and everything. And a beautiful historic house hotel. And we had a dinner and a dance. And when I taught it up, we had just in that room alone. Over one year, we had contributed one over 1.2 million pounds worth of placement hours. And to the NHS, which I think is pretty incredible. And each of the tables was named after an inspiring midwife who has passed on, such as Mary Cronk. So we all learned a little bit too. And I thought I would share with you the little gift that we all got. Because this is about connection too. So we had, everybody had one of these little presentation boxes. And I don't remember if you can see, but I had these made. There we go. Can you see it's a little badge? There we go. I think it's the opposite. It's a little badge and it's got a little silver baby in the middle there. A little enamel badge with our icon. And as I leave you this evening, and you've all been very patient with me, I thought I would go in sharing what part of the toast that I gave at the ball. So this badge signifies a bond between us, the founding of a permanent kinship in this ever changing world of midwifery. This promise starting in the hearts of the midwives back in the midst of time and perpetuating forwards for as long as a human exists. If you give me your word, then I will give you mine to create peace in the births of our nation's babies and uphold midwifery forevermore. Now we can't raise a glass. So let's raise our thoughts for all the safe hands and warm hearts which will care for all of our world's babies because we are all needed, yourselves included. So thank you for being so nice and listening to me. And these are the references, I'll hold it there. Whilst I hold these references, I'm completely happy to take any questions. I'm going to open the chat now. Thank you Marie, that was very inspiring. We have lots of comments on the chat box. Let me just go up. A beautiful analogy of the mushroom. I really enjoyed that. There's a lot of comments around teamwork. From Lauren, she really enjoyed the interesting link. Sorry, there's an echo. She really enjoyed the interesting link where she said that we really do need the support of our colleagues and wider teams without them she cannot imagine. Celine had a very interesting quote from Simon Sinek. A team is not a group of people who work together. A team is a group of people who trust each other. So very interesting comments coming in. Let me just say. Remember, we are open for questions to Marie. Well done Marie. Wonderful presentation. As you think of questions, maybe Marie, I have a question. Have you had a favorable placement as a student? I have indeed. I really enjoyed working in community. A standalone midwifery unit. The reason being that there was such a wonderful mix of antinatal interpartum and postnatal. And I really loved the staff there. They were very, very welcoming. So much so that I actually left my mug there and the hope that I'd end up going back. Beautiful. There's a question from Sarah. What feedback have you had from families about the connections you have made with them providing continuity of care? That's a great question, Sarah. My most recent experience, the mother reached out. She was in a very vulnerable position. And I did not leave her side. And she said to me, you're like my sister. And that meant a great deal to me. That really did. Because we're all human. So and continuity of carer really humanizes birth. And I really believe it makes being a student midwife much more profound in experience. You learn more too. So that was a nice feedback. And trying to think back to any others. The lady who had the first case study I gave with the connection, she gave me some wonderful feedback. She said, you just let me get on with it. It's what I needed. And so, yeah, and that's wonderful when a woman believes that she's in charge. And you are just facilitating in the background. And the priority, I think you're doing a good job when you get that. Thank you, Marie. There was a question from Lauren. Connection trust support continuity of care for families. She, she, she. I guess that was the question. Is there how do you build on connection trust and support for the families? And maybe Lauren, and if I've gotten it wrong, you can just probably clarify it. I think with continuity care, you are able to build a more profound connection with people because you're able to spend more time with them. You are able to go away and research what's pertinent to their case and then come back. And that can be wonderful for people. They, they don't have to keep explaining their complex needs. Or even if they don't have complex needs, they just, they can just relax. When we meet somebody new, no matter how lovely they are, we're, we're, you know, our barriers are up until we get used to one another. We have that into subjectivity. We build that up together. That takes time. And I think it's, it's more effective as well. Thank you for that. There was a comment from Katie. Love this Marie about the, you know, the, the music. You know, the, the, the, you know, the, the, the, you know, the, the, the, you know, the, the, the, the, you know, the, the, the, the, you know, the, the, the, about the, you know, the, the music and she said, she often thinks of midwives doing a dance when they, when they provide care, moving across the room with grace and makes me think of the swing your belly session today and all the biomechanic courses that will be funded. That was that to announce today. So very good connection there. Let me see. Oh, there's a question from Celine and Celine also wanted to know, can you share the, the toast you did on texts? If you don't mind, there's a question on how to, how to, how to nourish connectivity in the context of fragmented care. I think by having a team that works really well together, you're creating a, an environment where, where people, you're able to focus on the families themselves as opposed to building into subjectivity between the teams. So that's a good start. And staying up to date and being able to, to move from one type of case to another. I think that that helps. Thank you.