 So, let's start. We are ready to start. I would like to introduce our presenters. We are very lucky today. We have Serena and Nicolaci, Agnese Lecis, Adz, St. Fredonzani, Caterina Pozzani, Giulia Tofolo and Valentina Volpi. So, it's more than one presenter. This is a café. So, we are going to encourage questions throughout the presentation. They're students and they're all in the twenties taking the master in midwifery sciences at the University of Milano Bicocca. As they say, they find this path quite challenging, but they also find it very rewarding and they're very motivated to explore aspects of midwifery in a deeper way. So, that's why they are now interested in researching the internationalization of midwifery and also sharing experiences with other midwifery students all over the world. They participated in a work experience and student exchange program, and what we're going to discuss today, they're going to present as the result of this work experience. They want to learn from other cultures. They're eager to ask and answer questions and they want to give more visibility to the professional values they learned throughout the working experience. They spent in different European countries and also in Uganda and I'm passing the microphone to Serena. Good morning. It's Agnes speaking. So, I'm the one with pink shirts and I'm here with Valentina, the first one from the left. Astrid, the second one, and Serena, that is the one on my left side. We, as Marina said, we are all midwives and now we are attending our first year of the Master in Sciences at the University of Milano Bicocca. One of the stated missions of our university is to teach its students to size the world's opportunity and not to be frightened to confront them and put themselves out there. For this reason, our university offers three programs for internationalization that are written in the slides. So, as you can see, there is the Erasmus for studying, Erasmus for trainship and the exchange extra one. So, the Erasmus is for the European countries and in this moment we have some agreements with Tallinn in Estonia, nothing I mean the UK, Antwerp in Belgium, Atene in Greece and Ljubljana. And speaking about the world, so the exchange, so extra European countries, we have Campala, as Marina said, that is in Uganda, Jerusalem and Istanbul. All these programs are for us to go abroad and for other students to come to Italy. So, it's an exchange. And I wanted to say that in accordance with the theme of our International Day of Midwives, internationalization, as we will, we show you, provides new instruments to be defenders of women's rights. So, we shot some interviews to some students that had Erasmus and exchange experiences during the Bachelor. Connection reasons, we were not able to show you the video. So, we translated and wrote the interviews in some slides and now we are showing you with some pictures and with the text. So, the first question was, what's your name and where it being so we are now presenting you all our students. Hi everybody, I'm Valentina and I had three months' traineeship in Tallinn, Estonia, at the Healthcare University of Tallinn. Hi, I'm Astrid, I've been in Valencia in Spain for three months. Hi, I'm Sara, I've been in Antwerp in Belgium. Hi, I'm Serena and I stay in Italy, in particular in Monza, in the Northern. Hi, I'm Maria Grazia and I went to Kampala in Uganda, Africa. So, this is Anise and I've been to Nottingham in the UK. Hi, I'm Anna, I've been in Tallinn, Estonia. And me, it's Silvia, I went to Kampala in Uganda. So, the first question was, what prompted you to leave? I've always dreamed to take part to the RADMOS program and I have always had a desire to explore new corners of the world, discover new cultures, different traditions and I was looking for new stimulation which would provide me with smiles. It was a little dream that I have since I was a child. Later, studying midwifery at university and choosing this path in my life, I decided for that reason to go to Africa. The interest for another culture overall for the place where many of the guidelines that we study are created and also getting in touch with another way of doing midwifery. The will for something new to meet a new culture and face with something that I had never done. So, I forgot to tell you that after every question we would like to discuss with you. So, if you want to write any question or to speak to us, just do it. So, now we are moving to the second question. That was, how did you get training? I got ready to live in a very practical way. First of all, taking care of the bureaucracy, filling the documents, getting in touch with my internship coordinator in Valenza, renting my room in Italy and looking for a room in Spain. Asking to the girls that had already done this experience previously to get information about the internship in order to have realistic expectations. I could get in touch with some people that had already been in Nottingham, or in the UK, who explained me how it worked and helped me with the practical stuff. I got ready by finding info about the midwifery assistants in Estonia, how it was organised. I asked some students who had the same experience before and I looked for some information about the city where I was growing. Not only for sisters, but also to live for three and a half months. To be honest, it was quite a leap in the dark, without much preparation apart from practical things. Which shoots I had to get the passport where I would sleep. We came from a very stressful internship period here at home, so I didn't really had the time to think about where I would go. It was a sudden departure. For all of us, we had the chance to prepare with all the practical stuff. And also we found that the help of other people that were there before helped us a lot. So if you don't have any questions, we just go to the next. How did you adapt once there? I think that to adapt the best when you do an experience like this, it is important to feel like a guest in the country you go live in. Always keep in mind that people we get in touch with don't know us and our background. And they often have an idea of normality which differs from ours. It was difficult at the beginning. It took a lot of time. The word I used to describe the very first day is panic and another word is chaos. Certainly it was not easy because it's a different environment, but with the help of other people and with some time it was possible to adapt. Trying to know the lifestyle of the Estonians in Tallinn and going around, wandering in the city and then obviously going to the hospital and the university to see how they were organized. So once more we saw that the first time is quite hard, but with time and with the passions it was possible to adapt. And I think it is important to underline what Astrid said so that we have to feel like guests in the country we go live in. So Marina asked us if we left your experience abroad immediately after your experience. Yes, so we did our Erasmus and the experience abroad during the bachelor. So the three years of university we do here in Italy. And it was only clinical practice, so traineeship. And so we did it in the second or third year of bachelor. So how did you manage the difficult moments? I had the opportunity to think about some issues during the whole experiences. I was lucky to have a classmate who came with me and with whom I have always talked about the negative and the positive experiences. Before leaving Italy, a close friend gave me a diary and told me to write the experiences that I would have lived in Estonia. It has been very helpful and supportive. Trying to see them as opportunities abroad and certainly learning to rely on others. To share my difficulties with the people I met in Valencia and also learning to trust me and my skills. Talking with other people and sharing also with my classmates who were abroad. How I test them at the beginning like I always do, shutting myself away. Then certainly talking about them, talking a lot. So another time we see that it is important for us to talk and to share our experience with other people, friends, classmates, tutors and teachers. And that helps us to look at the problem in another way and to find the positive in it. Do you have any questions as far as now? Okay, so if you want just write or talk. And now we go on. So the next question was what it meant to you to meet another culture? Meeting another culture means questioning oneself, questioning the habits, the idea of normality and learning to appreciate the hosting culture, but also valorizing one's own culture. Living in a foreign country in touch with another culture allows you to feel on your own skin what it means to be a foreigner and feeling welcome. You just have to roll with it. I mean, you have to consider the existence of some priorities different from ours. I was in touch not only with the typical Belgian culture, but also with the Jewish culture because the presence of a lot of Jewish community and with the Turkish and Moroccans ones. The letters are much more lavish and intrusive than the Jewish culture. That is very reserved and with different beliefs like the prohibition of eating right after giving birth. Thus accepting a different health care management. Well, certainly within the hospitals I saw, many different cultures mix up together. The best part was to realize that our other cultures gradually become part of our society. This experience enriched me both from personal, emotional and professional standpoint. It definitely was an enriching experience even though difficult at the beginning. It gave me surely more tools to be able to do my job wherever I go. There was the chance to put myself out there and to second guess me and reconsider all my certainties especially from the standpoint of the midwifery care because I have always been involved in the same care model and the moment when you deal with a culture of background that leads people to have different needs your way of taking care of people necessary changes. If I have to use the term enrichment because it really helps you so much opening your mind in a way that you never could imagine. At the beginning it has been thought. There are a lot of things that you try to understand but in the end you realize that there is nothing to understand. You just need to accept something that is different with respect to what you know and embrace it out. So we are now starting to understand the importance of internationalization also for our job. So for us it was very important and enriching to meet other cultures also because it will happen in your job. So as Serena said for example even in Italy so even staying here you meet lots of different cultures. So it is important for midwives to know how to manage it. So have you noticed differences in midwifery? I noticed a lack of one-to-one midwifery care. The possibility of midwives to stay with women along the whole birth event was the hardest part. Well in my opinion there are a lot of differences between Italians and Spanish midwifery care. These differences are especially related to the distance training undergone by Italian and Spanish midwives. Indeed in Spanish midwives used to study for four years as nurses and only after the degree in nursing they get academic training in midwifery that lasts two more years. Their approach, their formament is more interventionist. What impresses me most is the rate of women that requests epidural is around 95% in Spain against the 15% in Italy. Certainly the main difference that I noticed is that during the event of birth women are mainly assisted by gynecologists with minor support from midwives. During the whole care path since the arrival at the hospital to the second stage of the labor women are assisted by midwives but for the birth event gynecologists who took care of the women during pregnancy takes over. There was this difference. I'm wondering if the midwife takes care of you for all you label and then you expect to be assisted by the gynecologist but it's because it's the only person that she knew and that took care of her during all pregnancy. I certainly noticed some differences related to a different cultural background also in terms of regional assets. The difference is probably related to the distinct healthcare system. Midwives have the chance to devote much more time to women during the outpatients, pregnancy and breastfeeding services. There was really a lot of time for each woman. As women tended to be more extroverted and were able to feel welcome in the 45 minutes allocated to them. It makes me laugh. I mean, I had a lot of expectation when I left. That have been completely degraded. It expected a psychological care. Whereas I found an extremely medicalized religion. Does I had to familiarize myself with that view? I expected women to be free to move within the delivery room in Africa. Whereas they were, for example, lying. You know, too medicalized, yes. So, as we saw, for many of us, there were some differences in midwifery that were shocking. But it was important for us to understand them and to know why there were these differences. To improve our practice or to know what is better. If it's better, what we do here or what they do, where we have been. So, we have a question from Nora. I think Astrid can answer. So, the question is, do you notice clinical practice differences between the midwives who trained as nurses first and then completed midwifery? So, I think she is talking about what Astrid that was in Spain said that midwives to be midwives have to do to be nurses before. Well, in Spain, to become a midwife, you have to get a nursing degree. You have to practice for and study for four years as a nurse. So, the practice of the Spanish midwives is more interventionist. They are more practical with medicine, with drugs, for example. And they used to suggest to the women the epidural instead of more natural ways to face the pain, for example. So, yeah, I think the main difference is that if you are studying nursing before doing midwifery, you start from a pathological point of view and instead we start from midwifery degrees. We learn to. We learn to start from physiology and to protect the normality of birth events. I think it was a bit challenging at the beginning, but really interesting. The Spanish midwives I met there were really interested in listening to me and learning from our different ways to assist women. I usually talk with them about aromatherapy or digital pressure to induce the labor. And they taught me about more drugs they used during the labor of the women to reduce their pain. In Italy, we don't usually use this kind of drugs. Okay. So, if you have any questions, just write and we will answer as going on. Okay. So, the next question was, would you recommend with experience? I totally recommend with experience to midwifery students. First of all, it gives you a chance to improve your knowledge of the foreign language or to learn one from scratch. In my case, I learned Spanish. Before going to Spain, I didn't speak a word of Spanish and now I'm quite fluent. Verasmos Project gives you a chance to become able to adapt and flexible to different situations and enables you to grow on a personal and professional level. Well, I absolutely recommend this experience. It's not only a traineeship or clinical practice, but also a life-changing experience. You learn to get by on your own and to understand how extensive your knowledge really is. If you have to explain something in another language, you have to focus much more on what you are saying. And this makes you understand what you have to revise. It lets you understand if there is something you need to study better. Precisely because you have to explain it in another language. In other words, I believe it's a useful experience. Even though I didn't do my internship abroad, I have the chance to face many different cultures. Thanks to the several foreign women and babies I met training in Italy. They allowed me to learn about the world, not only about my country. I absolutely recommend this experience. From experiences like this one, you can learn many life lessons from both a professional and a human point of view. Among the strengths of this experience are the knowledge you acquire, the relationship you make and the cultural richness you meet. I know it sounds like a cliche, but knowing about the mentality of other countries is really a great skill to have. I can see now that I'm back when I take care of foreign women. Now I can understand them much better. I totally recommend this experience. So now we are saying that this was a very positive experience for all of us. We started from a hard moment that we showed before. But coming back, all we can say is that it's a very positive experience and that we recommend it. And that we have now more instruments to do our job here. Okay, so do you have any special moments you want to share? I have many great memories from this experience. I remember fondly a woman I had taken care of during the entirety of her labor until the delivery. I met her again alongside her mother, the grandma of the baby, a couple of days later in the hospital. And they were very thankful for my assistance. They told me that I had made the difference in the baby's birth and that I had contributed to ensure that the mother would be sure that important event forever. It struck with me because she was the first woman of whom I had taken care during her labor in my traineeship in Spain. Even though it was my fourth week in Spain and I couldn't speak Spanish, I managed to build a good relationship with the woman I was taking care of. I am very fond of this memory. It showed me how important non-verbal communication is in our job. Apparently, one of the last labor I assisted in which although there was a language barrier, or in any case I could not express myself in words with that woman, I believe she experienced a very positive childbirth and it was the same for me. There were an harmony despite no words saying. Because I saw this moment as the most natural event in the world, as it really should be. And seeing just how naturally and easily these mothers took their baby even if they were premature and attached them to the breast without all these problems that there were around. It was a beautiful thing. So I have a lot of images of breastfeeding that I really carry in my heart. The moment when I felt myself more part of the English community where I was and when woman trust me and it was possible to create a beautiful and positive relationship with them too. I cherish in my heart the last foot in the breastfeeding center when the midwife who was my trainees assistant almost started crying because I had to leave and she told me she was jealous that I would become an Italian midwife and not an Estonian one. She asked me to come back once I will graduate and told me to go on as I was doing and not to lose a strong passion for midwife. So as Marina is underlying in the chat it was very important for us to understand that our job is not only verbal and words but is beyond language. So even if we were abroad, even if we were not able to speak the language, the native language very well it was possible to create very important relationship with women and so that they had positive experiences of their childbirth. Of course this happens even in our country if we meet women that don't speak our language. So the last question is to describe our own experience with the slogan. So they are just short phrases that explain what was more important for us. Leave the experience with high head, heart in hand and smile in pocket. If life doesn't kill you routine will do. In my opinion in our job but also during life in general it is important to find new motivations not to settle on one's own habits but to always find reasons for personal and professional growth. Prima, which means strength and encouragement that was saved to all women during childbirth. Stay in Italy but with the heart in the world. One word sister, it was used by everyone among midwives but between mum and midwives and indeed among all women. It is a word that well describes the relationship that it creates in the family community like a sister would actually. Don't be afraid, leave because it's worth it. Leaving to change and to know because when you leave you expect. You have so many expectations and when you arrive all these expectations may be destroyed and then you have to return to zero. Change your way of thinking and seeing things in order to meet a new weight. Diversity is a gift. Learn to consider it like this. So that's all. We would like to know if you have any questions, if you have any experience you want to share with us. We are learning that in Sydney, Australia they call each other sister a lot. I think it's great because it's really showed sisterhood and the relationship in the female community. That's fantastic. Thank you so much for sharing the experience. We have nine minutes left so we're perfectly on time. You can ask questions using the microphone or using the chat as we've been doing. I have a brief question because you mentioned language so much. I know in Australia and we have a participant from Australia Nora. Because in Australia you have translation services in the healthcare system but I don't think that's the case in Italy, is it? Yeah, it's different from hospitals in every hospital because you know in each city you have many different cultures and people coming from other countries. So for example here in Monsa where we are studying there is a great community coming from Bangladesh or from the Arab languages countries. So we have actually a midwife who is speaking Arab, French and many other languages that help us with these women. For example in Milan there is a great large Chinese community. So in many hospitals they have midwives for Chinese that help Italian midwives during the assistance. These midwives usually are not just translators but cultural mediators. So they help out not only with the language but with the culture of these people, of these women. Fantastic. So the midwife is the cultural bridge and doing the translation as well. Excellent. We still have a few more minutes. Would you like to expand on any points that you've shared already? I'm curious about so many things that you said but I want to encourage questions from the participants in the chat. I'm curious to hear also more from Maria Grazia. You said you were pleasantly surprised about breastfeeding in Uganda. Could you give an example of the differences that you find with Italy? Could you compare them a bit more? So Maria Grazia is not here with us but she was saying that in Uganda where she was it was very natural for the women to breastfeed. So they didn't even consider other possibilities if they were able to breastfeed even premature babies or babies that were sick or even if they were not very well talking about health. So it is different from our culture because sometimes we see some problems that may be, that may be there. That may interrupt breastfeeding but in Uganda it was all more natural. So they were very happy to breastfeed and it was their only chance. So I want to thank you for speaking also for Maria Grazia and I think you found a great way to present such a variety of experiences because staying in Italy, going abroad, in the end you connected everything and presented it in a beautiful way how it was so interconnected. So just to make a conclusion, we are very happy that we had the possibility to do this experience abroad and talking again about the team of our International Day of Midwives to defend women's rights. I think these experiences gave us lots of new instruments to do this so to defend our women's rights and during all our clinical practice. Thank you. Thank you so much.