 So I'm just going to introduce Meng and Irene. Meng Xurui has more than 30 years of experience and passion for midwifery, and the women of families who put their trust in midwifery services. In 2010, she organised the Midwifery Annual Conference in China, which is the national-grade learning and communicating platform for midwives. Meng Xurui is also the founder and director of the holistic and enhanced modern maternity services system, the MMSS in China. She has made outstanding efforts in her contribution to supporting the normal physiological processes and her contributions have led to and continue to upgrade and develop of midwifery services in China. She's passionate about childbirth and about integrating traditional Chinese medicine and culture into maternity services and believes that the integrated model is the future of China's healthy and thriving nation. Irene Chang Kalnowski has practiced midwifery for 38 years and has spent her entire life passionate about midwifery, working across continents, observing systems, and learning more wonderful ways to deliver care and relate to women. She now lives and travels across China with the MMSS team as the midwifery advisor, supporting the implementation of integrated holistic maternity care and midwifery. That care puts the psychological, emotional and physical health of women, their babies and their families first, giving them voice and choice in all matters. I'm now going to hand over to Irene and Meng. Okay, if you can unmute yourselves now. Okay, so this is Irene and I'm just going to introduce Meng Xurui. I'm happy to have been with her for five years travelling across China, making wonderful differences through education and face-to-face training. So I'm going to pass you on to Meng Xurui who will talk to you a little bit about how we give midwives autonomy and voice and choice for women across China. Okay, Jenny? Okay, so last year you heard about Project One from Guangxi, Barma County Peoples. The first project was in Tiandong and today we're going to talk about the second project that we've got in Barma County Peoples Hospital in the remote areas of China. Okay, hello everybody. I'm very happy to share MMSS team and Barma training. Now I begin. After training months of training, the sex rate decreased from 26.89% to 20%. If you see no tummy rate, decreased from 6.4% to 1.4%. Okay, next one. Slides are not moving. It's coming okay. We've got a problem with the slides coming. We can see them have gone on to the next slide. We're on slide 15. Nothing's showing on our screen. Hang on. Okay. This is Barma Hospital, please. This is Monkey by the Mountains. I hope the Barma Hospital many, many BB births. We're just coming. I think it's loading. Okay. Big member in the 80s, 2018, the MMSS project, the opening subremonings of Barma. Okay, next one. There have been experts in education and training. The foundation of MMSS, Chinese traditional culture, Wang Yangming. This is important in the hospital training. Let every staff change the mind to have a happy walk. Happiness in the workplace. Okay, next one. Next one. This is looking, the maternal age, 30 to 22 years old, very young. This is a poor family who has experienced six births. This family not go to hospital to take the body. So in the home, poor birth. So they're both at home still and there's no prenatal care because it's up in the mountains and very difficult to get down. Yes. The children here are in a very poor environment because this area is poor in China. MMSS expert team came to the family to guide a postpartum mother to recover from sinfesis, subretion and pain. So the family couldn't get into the hospital for care. So we went to the home visit to fix this, to provide holistic care for this family. Yes. Our team gave the treatment and the nursing method. The first of all, there's no therapy, pubic semenosis suppressing in central oil formula. The second, homeopathic separate semenosis and postpartum would healing. The three Chinese medicine teach traditional massage after six hours mother can get up and breastfeeding and walk. On the second day, she can walk on the first floor. On the third day, she can walk downstairs to the street. She's the first ring of some signs after the birth and they invite us to have dinner with the family. We also made the first postpartum home visit to Obama. After 10 days of treatment and the midwife recover, the mother shows a happy and confident smile. The second case, 35 weeks, the baby died in the womb. The expert group launched the energy care with confidence to the extremely pregnant woman, giving her pre-mosal oil to soften the cervix. After 20 to 25 hours, they gave her chemotherapy for postpartum recovery. The mother was degraded from the hospital. The third case, worry caused veins after seaxing, peeling of the soles of the feet, dryness, muscle, relaxing of the legs, safe repoint, low energy, depressing, worry about worry caused veins. Insomnia, hope diagnosis, aromatherapy, acupressure, the family relays in shape, support and other methods. The mother improved. The case for the first child woman is 17 years old, pre-nutrition, emotional delay. The fifth case, after the vaginal delivery of the second born mother, the mother's left leg and pubic thin facies pain. We give her chemotherapy hot compress, Chinese medicine, acupressure and other nursing methods and the effect is remarkable. The sixth case, 20-year-old woman first pregnancy, five days treatment of vaginal cysts. We use the essential oil formula to the effect area and homeopathy to support healing. 50% glucose compressor, magnesium sulfate compressor. Next day, the abscess naturally ruptured pain stopped, then held no antibiotics used. The seventh case, infant ectema was treated with western medicine. Hormone, I admit, did not work. Our team applied ectema essential oil formula to the affected area and Chinese medicinal massage. The baby's skin improved and so did sleep and mood. Eighth case, the second child vaginal delivery at full term. No interventions in the whole process. The baby and the mother screen-to-screen and eye contact. The MMSS expert group meeting with the president head midwifery and director of optitricks. MMSS expert group works more than three hours a day. Hypnosis teach. We use hypnosis for teaching. We educate the midwives and obstetricians to use hypnosis. Okay. This is the key to the hypnosis. This is classroom teaching and we're teaching the midwives and obstetricians hypnosis. In the midwifery clinic we teach how to do within the woman. We teach the experts how to use how to do midwife and obstetric clinics. We use lots of educational tools to be woman-centered. We're moving from system-centered care. We're also looking at teaching correct abdominal palpation and how to really connect with the woman. We use acupressure points to also help reduce stress. And we're also bringing the MMSS experts to teach from all over China and from globally as well. So we get lots of hands-on face-to-face training. We do theoretical training, evidence-based practice for at least two weeks for each module. Okay, after the training the midwives has undergone a significant cut, change, treating the woman and caring for her as a daughter. So first of all, the producing Citing, her husband supported her before the husband no counseling. Not a lot in the delivery rooms. This picture is a natural delivery after two C-section mother-in-fact skin-to-skin to activate the first breastfeed. MMSS team established an obstetric appointment center an obstetrician clinic a midwife clinic and prenatal education. Obstetric clinic, midwife clinic a call a call just happened to be involved involved before the husband not in the clinic. Each clinic is equated equipped with a prowess and a draw and educational test. MMSS R3 attaches importance to comprehensive preventive health education. MMSS obstetrician experts professional training obstetric in emergency and ultrasound. Before in China the midwife and obstetrician count to do ultrasound. MMSS lets other staff midwife and obstetrician basic skill ok, professor Edison said that if an obstetrician would do a basic ultrasound it would help the mother to solve 90% of the problem at the time of delivery. This picture MMSS experts what wrongs with obstetrician and midwife. This picture is MMSS experts private and teach health education for pregnant women and families. This is Erin to do. This picture is MMSS training infant water education before the baby not to do swimming now. This is Obama obstetric team obstetric team daughter team midwife team midwife team ok and for our foundations for our training we make Sue and I have actually delivered the books the prenatal education manual, we've done a labour and birth manual and to follow is the postpartum care manual which will be the basis of integrated comprehensive care for all hospitals in China working with our MMSS project. So thank you all we wait for your questions. Thank you all for very interesting presentation and with lots of photos it feels like you're right there. I have a question for you does the team and the experts so they come from the staff that you go to to the hospital that you go to or are you bringing in new staff to that hospital? No we bring only experts that have a holistic integrated midway free mindset so they come from around the world and they also come from our MMSS team that we choose from experts across China they must at the hospital so they can continue then? Yes so we plant the seeds in the hospital and then the hospital team become the experts and they come and teach us, I hope. Excellent. That sounds really good. Okay so if you have any questions just pop them in the public chat box. I think that Meng's done a really good job because she's only learned English this last year so I think she's going to bring it up. My English is very personal I'm very sorry I have five years in China all I can say to the midwives is what any, I love you! Yeah, maybe for example isn't it? I want to show you more but my English is not good so maybe next year maybe if you're all coming to the integrated conference in New Zealand in September we will we're working on the English. Very good. So is this the third hospital that you've taken the MMS project to? Yes it's the third one and it's the MMS project that we're putting into whole hospitals but we've been training for the last 12 years across China so many many hospitals and we're going even bigger because Meng and I have designed a midwifery training curriculum for comprehensive care and to be working with the midwifery colleges to implement it so it all tallies in with your presentations that you had earlier so it's wonderful we're so excited I think we can help them go to the university teach the midwifery, use the MMS Yes we're teaching the midwifery educators to use the MMS philosophy framework and background for midwives so that there will be a continuum so the student midwives will have systems supporting the midwifery philosophy we'll have a continuum so we're very excited I think we've lost the sound No I'm here, I just thought it was amazing Meng has a question here do you have any information on the outcomes of your project? Yeah well we're collecting data it's in the early stages we're collecting data each month from the hospitals to see the changes and we're actually starting research a research centre will be developed this year so yes we are collecting as much as we can and we're getting the experts to come and help us because we're jack of all trades but not master of all of them How many outcomes are you interested in getting? How many what? I didn't hear that What sort of outcomes are you interested in? Yeah everything from not just birthing outcomes and hospital outcomes but outcomes from the midwives and feedback from women and to actually start new research with the integrated care we have a software system that's just been developed it's just been transcribed into Chinese to help us with this So we're going to monitor student midwife outcomes and training and that will inform our research and education Awesome and can you just let the people know who are listening what you mean by the integrated care what factors or what different areas are brought into this scale around the therapy What else do you bring in? Well we have midwives and obstetricians in the same classroom in China and we teach them all the basic skills for aromatherapy, homeopathy hypnosis, massage all the things the midwives should be able to do we believe all those basic skills and safe skills and we've got referral guidelines for what they can do and what they need to refer onwards For the midwife research we can do so we teach all those skills because our ex-brother team have a doctor midwife and a nurse and another expert together so we are a big team Yes and we're growing, we're growing very big we're growing rapidly and we've got more and more hospitals queuing up so we're going to be constantly growing so we're very excited We're going to do this 10 years 10 years ago again to do this we're growing fast and changing mindsets because if you're going to the cities a lot of Chinese women are so used to see sections and medicalised care but we're coming out from the remote areas so we're sweeping inwards we're coming from out within to make these positive changes happen and they are happening And so the reason why we're doing that is because there is a different philosophy or mindset around birth You've got to look at the history We've got more Chinese hospitals Chinese medicine hospitals out in our remote areas because you have to remember what happened in 1929 when they sent the missionaries to outwash Chinese medicine homeopathy There were actually four homeopathic hospitals in Shanghai in the year 1909 but this was all wiped out with our pharmaceutical research So if we go to Beijing it's still medically controlled you've still got obstetricians controlling birth and it's hard to break so we're coming in from the outside because midwifery needs to be where it needs to be and in an integrated form So we're bringing back Chinese tradition and we're bringing back the philosophy and we're integrating care So we have a question from Deborah Davis here I'm also interested in Chinese women's expectations around childbirth Is physiological birth something that is desirable? Of course all women want physiological birth except for we have such a high C section and it's just no different than if you go to Australia and other countries where women have been shown the medical way and they accept it and we have to change those mindsets in the bigger cities but if we're in the rural areas the women want normal So it just depends which region we go to every province is a little bit different So we're destined to change these mindsets and we are seeing normal birth and we've got the Chinese government supporting us supporting that they want that reduction in interventions and C sections So we have that support Yeah that's really excellent How do you find I guess if you have such a high C section rate or first cesarean how do you see the reaction around VBAC and are women keen to try for VBAC? Well that's because yes they are because we created prenatal education around VBAC and because we've trained the obstetricians to have a midwifery mindset to support normal philosophy, physiology So we've got midwives and obstetricians on the same line which we don't see in our western countries I never saw many obstetricians in the same classroom learning about normal birth with the midwives and this is what we're able to do here in China Yes before the obstetricians not learning normal birth So now we are training all the staff about normal birth So we have obstetricians learning about how to move the pelvis Yes And they're showing the women in the obstetric clinics how to move their pelvis because that's the way it should be Absolutely that's fantastic You don't end up with a divide then with them and us culture which is what happens in me and the countries If you're all starting from the same viewpoint then obviously women are going to benefit from that It's a huge difference and also the thing is that we not because we've all got the same philosophy what I've found as well is we've got systems supporting everyone I've found that as a midwife you go out and you're a woman's voice but then you're dealing with a meditally system so then you end up taking the bullets and you get stressed out which is all what about we had earlier in the presentations today So we're trying to avoid that to preserve our midwives and obstetricians and keep them happy in the workplace and love their job and then women benefit too Thank you so much Questions, I can't see any there There's some very positive comments thanking you for the great job you've done and it's a great step towards changing practice and we need obstetricians from all countries to be this open minded Yes some very positive comments for your work so hopefully in future VIDMs you can come back and tell us more about the projects that you have done Hopefully next year we can talk about the model that the curriculum was put together for midwives and also we're very proud because Mainsture and I met and we're both midwives leading this chain so we feel very special It's an energy field where midwives know about their normal labor That's right That's why we can change the obstetric mindset here which is so much easier and that's why we appreciate all you midwives across the world with the challenges that you have So thank you