 I want to welcome Bourjou. I have tried so hard to get this pronunciation right. I'm not going to say it anymore, I'm going to have to say it myself. We actually met, I can't remember where we met, but it was a European Betwares Association meeting. And she's such an enthusiastic woman. I'm so looking forward to this presentation. Bourjou, how do you know that, Lindsay? Anyway, so I would like to introduce Bourjou, who is vice president of the Midwives Association of Turkey and head of the Midwifery Department at one of the universities, which is unpronounceable, in Turkey. Over to you. Over to you, Bourjou. On you go, on you go. It's me, my turn? Yes, on you go, over to you. And thanks so much, Linda, for everything you do for Midwives. Really good job for the advice all over the world. And thanks so much for all team and who arranged the virtual conference and who arranged this platform in here. So I'm so happy that to meeting with you in this conference. So I'm the first Turkish Midwives, I think within this conference, but I'm really so happy and maybe I'm sure the next time, next year, we are going to be more Turkish Midwives within this conference. So thanks so much with the lovely conference as well. So I'm going to start with my presentation. And, oh, sorry, just, I will, yeah. And my colleagues is Dr. Nazan Karahan and she's also president of Midwives Association of Turkey and she is the head of the Karabakh University as well. But she have another meeting at Ankara and Difters now and she's so sorry about that. She's not income this room now, but I will present both of us. And this year, International Day of the Midwives in 2018 and Midwives leading the way with quality care. So we celebrate this them all Turkey and we celebrate these them all Turkish Midwives in all city and all country in our country. So I would like to put pictures in the IDM and ICM resource pack. So I will translate it from English to Turkish to ICM resource pack. And we use the resource pack to celebrate all Midwives in the same them and the same information with all of the Turkey. And the another pack I will put and the Turkish Midwives, yeah. I will start the midwifery in Turkey and midwifery in Turkey together with teaching and nursing in one of the first female profession acquired through education. The title of midwife is given to those who graduated from a faculty or college that provides undergraduate education of midwifery and whose degrees were registered by Ministry of Health in Turkey and who completed their education abroad in a school related to midwifery and whose equivalents were approved and degrees were registered by Ministry of Health. Midwifery is a science and art based on knowledge and moral values with a theoretical and practical education. As per the law, no 1219 pertaining to the most of the execution of the art of medicine and its brains in act in 1928. Unsurped fate midwives were prohibited from assistant in childbirth and such participation was deemed as a crime. This is the first law in midwifery in Turkey. And midwives have to work to midwives in Turkey and midwives prepare and conduct the preparation, programs the pregnancy and parenting before the pregnancy, monitors and reproductive health of the women within the boundaries of fertility and identify pregnant women and carry out a normal pregnancy follow-up and necessary examinations, identify risky situations and send them and conduct the birth process, monitor the health of the mother and the baby during the travel, conduct the normal birth and emergency medical bridge deliveries in cases where there is no doctor, perform episiotomy if necessary, identify abnormalities in the birth process, take the emergency measures, inform the doctors and intervene in accordance with the directives of the doctor. And another one, do the first medical examination of the newborn in postpartum, do emergency registration if necessary, give breastfeeding education to mother, provide care for the mother and identify abnormalities and apply the drugs in emergency obstetric station in accordance with the protocols organized by the Ministry of Health Turkey and provide training and counseling services to protect and improve maternal and infant health during pregnancy, childbirth and postpartum period. Participate in screening programs for women and newborns of family planning services and monitor all six-age child care and development, participate especially in pregnant and all six zero six year old child vaccination, contraceptive disease, control programs and immunization services. And midwives do in Turkey and they are due to in Turkey. And midwives association of Turkey was founded in 1954 by a group of six people under the chairmanship of Hasiki hospital chief nurse midwives, Sekina Arjan in Istanbul University, Gerard Pasha faculty of health lights. The purpose of this association is to work for raising and improving the health of women, newborns, families and communities through the support and straightening of midwifery profession by taking part in professional developments and education practice. In this context, midwives association of Turkey, president, Sekina Arjan, attended the international congress of midwifery held in 1954 in England and made an oral presentation about history of midwifery in Turkey. Later between 1954 and 1978, midwives association of Turkey continued its education and development activities for the profession and played a role in the analysis of the duties of midwives by the directive. No, 154, which was issued in 1963 based on the law on socialization of health services. And at the 38th ordinary congress of the midwives association of Turkey on April 15, 2006, the statue was amended and started work again as midwives association of Turkey and with president of Dr. Nazan Karahan. The goal of the renewed midwives association has been to raise and improve the health of women, newborns, families and communities through the support and straightening of the midwifery profession. In the following years, the midwives association has made a very serious effort for the current midwifery law, but these efforts have not yet reached the creation. On the other hand, as a result of this effort, important legal arrangements related to midwifery and midwives have been realized in recent years. In this context, and following are some of these arrangements in this. And first of all, by amending the regulation and determination of the minimum training requirements of medicine, nursing, midwifery, dentistry and veterinary pharmacy and agriculture education programs, standardization, midwifery education and midwifery qualification documents has been realized. And another one, job description have been defined by the regulation regarding the jobs and job descriptions of health professionals and other professionals employed in healthcare services. And another one, in article one of the law on amendments to certain laws and degree laws, some paragraphs have been added to article 47. And it's dated 1928 on the law on modern execution of the art of medicine and the parents and specialist midwives and author to documents have been edited. And some arrangements have been made with regard to the incomes of specialist midwives within the context of the third period collective agreement of public officials. And another one, the most important thing, the new one is the law no 6,6339 and dated March 2015 having master's degree who the graduate education related to professions of the graduate diplomas are registered as a Ministry of Health and then work as a specialist midwives. So we do so many works but we have to achieve so many challenging as well in Turkey. And what's the status of midwifery education in Turkey? First of all, as I mentioned before the history and after I will talk about the current status and midwifery used to be a profession that has been based on experience and which pays from mother to daughter in Turkey. And in the 19th century, big cities like Istanbul and Izmir, midwifery was performed by women called junior midwives who were training a master appraisings system under the supervision of recognized midwives. The first midwifery education in our country begin in 1842. We are training courses and became the first female profession to be a character of vocational education. And in 1880, Dr. Besem Ömer Pasha who began to reach midwives has been the founder of the contemporary midwifery by restructuring this course with the belief that the midwifery applied profession and includes functions related to patient care. Dr. Besem Ömer Pasha set forth some criteria for persuasion in midwifery courses. He determined this interior criteria is being not more than 30 years of age and speaking and understanding Turkish. And he also made the necessary adjustment in the curriculum. Later, in 1909, civil and military medical schools were combined and Hyder Pasha faculty of medicine was established with a new staff. The first midwifery school and gynecology clinic were open in Kaderga. This school continued to fulfill its function without interruption during World War I. However, the midwives who graduated from this school did not want to assume duties in Anatolia so the need for midwives was not met outside in Istanbul. In 1920, female students from various cities who were primary school graduates were sent to Istanbul to receive education in boarding school and their travel expenses were covered by local municipalities. When they graduated from these schools, they were assigned to midwifery services back in their hometown. And there be meeting the needs for midwifery services in other cities to some extent. And after the foundation of the Republic of Turkey, 1923, this midwifery school was sub-ordinated to the Faculty of Medicine in 1924. Education given in this school was gradually improved under the directorship of Dr. Besmemer Pasha and students to be admitted to the school were chosen from secondary school graduates instead of primary school graduates. From this date, midwifery education has been conducted as second, third, or fifth year health schools midwifery on primary school education and as fourth year schools based on secondary school education. Midwifery education was promoted to four year vocational high school education based on secondary school education in 1969 and 1970, academic year. To associate degrees, 1970, sorry, 1985, 1985 academic years and to bachelor degree in 1996 academic year. And currently midwifery undergraduate education is provided at the state and private universities and in midwifery Departments of School of Health and is since 1996 and we changed like the level of the midwifery and from vocational school to faculty of health science midwifery department and since 2006. There are 39 midwifery departments in universities in Turkey and 34 of them are in state university and fifth of them are in private universities. Midwifery education reached master's degree in 2000 and doctoral degree in 2013. Midwifery education in Turkey has been formatted in accordance with the European Union criteria, numbered console directives and many declaration by taking into the concentration the international standards of the World Health Organization. Midwifery candidates who successfully complete the midwifery program in line with these directives are expected to have sufficient knowledge about occupational ethics and occupational legislation as well as educate knowledge and experience specific to the failed. On the other hand, within the scope of following the process, standardization has been made in midwifery education programs in parallel with other national and international higher education programs and what's the status of scientific research related to profession of midwifery in Turkey and doing publishing and using scientific research is a professional activity that requires significant knowledge and skills. Scientific research doing publishing and using is necessary for the development of professional knowledge and practice specific to the area of midwifery and it's also a way of developing evidence-based practice in research midwifery and many other disciplines and on the other hand, it's important and necessary for the research to have social and cultural features to be able to be used in practice and for professional development and it's necessary to look journals and scientific meetings where scientific meetings and research are published in order to understand the status of midwifery research in Turkey and because of the late start of undergraduate and 1996 and postgraduate and master's degree 2000 and doctoral PhD degree in 2013 education in Turkey scientific research activities are also activities also started late. There is city non-referred midwifery journal in Turkey however it seems that midwifery studies are published in journal related to nursing and medical facts and international publication have increased significantly in Turkey within the entrance requirements that was brought to associate professorship exam and which is the professor have to publish at least maybe to get some points at least maybe 40 points in one citation index journals and scans in the web of science and the first scientific meet and that's the obligatory obligatory for the professor in Turkey they have to do for to be achieved the professor they have to get some scores and they have to get really big exam and it's the promote and promotion for the international publication in Turkey and also the first and other good things in the midwifery scientific meetings the first scientific meetings related to midwifery were carried out by Ege University Ataturk School of Health and these meetings were the international participatory and midwifery symposium in 2007 and the midwifery workshop in 2008 and this workshop is organized by our university Cumhuriyet University and this workshop name is standardization undergraduate and postgraduate education study in Turkey and we invite the professor Valery Flaming in UK and there were a really successful workshop in our hometown and the first national midwifery congress in 2010 the first national midwifery congress was held in 2007 by Midwife's Association of Turkey it seems that the third national midwifery congress and international participation was held in 2013 and the seventh national midwifery congress international participation was held in April 2016 and in addition midwifery related studies are also included in scientific meetings held on nursing, children and gynecology and public health and environments for the sharing of these studies are being established midwives learn about research matters and bio statistics courses in undergraduate, postgraduate and doctoral education programs and in addition some courses, congresses and symposium organized at national and international levels are devoted to research methodology and publication issues and in this year 2018 and 24th and 26th on April and the arrange, our university, our midwifery departments arranged first international, fifth national civil midwifery symposium and it was really really successful 480 participants were there and we had 80 oral presentations and 20 posters and we collaborated mayor, governor, rector and all protocol in the city and we celebrate midwifery there all together, all midwives midwifery students, midwives, educators and all from the Turkey and I'm in Amasya now I'm in the hotel room and I'm in the big Amasya hotel now and it's running to another big congress and it's another in this time and third and fifth May and which is fifth international ninth national midwifery student congress and organized by Amasya University and the international speakers are Dr. Rita Borg Shurep from ICM Thornton Europe representative and midwife Serena Debonet is from ICM Central Europe representative and representative and there is a running congress and they are in the congress hall now but I'm in the conference and after the conference I will come back to congress hall and this congress is going to be very successful to support governor, rector and our midwives association and another midwives association and all midwifery students, midwives and researchers all together in Amasya and we connect and another congress which we have in seventh ninth November 2018 and it's coming, Izmir, Turkey first international midwifery education and research development congress and it's organized by association of education and research development in midwifery and Eke University and I would like to invite you for this conference in Izmir, Turkey and we are you are very welcome to Turkey and from all parts of Europe and all parts of maybe the most beautiful cities in Turkey is Izmir and within this context revealed current state of midwifery career with extent of its legal regulation education and scientific research in this context the following are result revealed in this discussion as well as continue midwifery law studies in Turkey significant level, sorry legal regulation regarding the midwifery training employee rights, duties, authority and responsibilities have been implemented midwifery education has attained an international standard and has been offered at undergraduate postgraduate and doctorate levels however a significant sections of midwifery education is still administered by members of other health professions including nurses and current scientific research on midwifery is in educate and according to the discussion conducting studies to midwifery law and supporting the work of the midwives of association of Turkey and in order to increase the number of instructors in midwifery in cooperation with the council of higher education and higher education institution providing midwifery education supervising current education given at higher education institution according to national and international standards and legal regulation and conducting improvement studies and these studies can be done by the education commission of midwives association of Turkey in supporting the work of the association of education and research development in midwifery and for the development of midwifery or conducting systematic and comprehensive studies by creating a similar working groups publication of wifery, journal in field of midwifery and supporting the studies carried out in fields are recommended as I mentioned before postgraduate in midwifery and before this slide I've got five minutes more just only Linda I've got five minutes more but I'm not sure I will be quick and postgraduate in midwifery postgraduate education we started in 2008 postgraduate programs universities are Mersin, Ege, Cumhuriyet, Kurova, Kocael, Istanbul and Adam Menderes and Atatürk University all the number of midwifery departments in in Safient, midwifery doctorate program has opened in Ege, Cumhuriyet, Atatürk universities, postgraduate education and postgraduate education as well as providing the experience in depth, knowledge and competence required by the relevant discipline and with this context an academic approach to program of midwifery profession in Turkey and I would like to mention about what's the opinion about the instructor in Turkey education factor instructor stated there should be the cost of the service provided professional organization and indispensable service giving to society and independent function and opinions of instructor regarding the legislation regulation of midwifery in Turkey and generally negative in this respect the general view of instructor of midwifery education in Turkey which means why is first job description where mid is not date and different laws and regulation in what expression the cost with nursing and which leads to employment problem in the country and another opinions of the instructor regarding the midwifery education in Turkey is observed why instructors assess the presentation in terms of midwifery education and the midwifery departments and its effect quality of education but there are such a less doctoral educated midwives professor and opinions regarding the requirements like midwifery in Turkey there are 55,000 midwives in Turkey and the examin seems to be compatible with the opinions of the instructors determining the low membership score for professional organization which is an important indicator of professionalism in their own work is an undesirable condition for the profession and the future plan we do employee rise, duties, authorities and significant sense of midwifery education and current studies and how to develop the midwifery in Turkey and I would like to put the international midwives idea again and I would like the thanks to for my presentation and inspiring me and I would like the special thanks to Dr. Nazan Karahan President Midwives Association of Turkey and professor Zeki Karacan and Dr. Mohan Yücel and colleagues and Dr. Seville Günar and colleagues and inspired their articles from Turkey Turkish midwives and thanks so much for your contribution in here thank you for all participants in all over the world I think so I'm so sorry I didn't check I didn't check the writing but I know Joy thanks so much thank you thank you that was fabulous my Turkish is nowhere as good as your English that was a wonderful presentation and I work out from what you said that you've done a lot of work recently in trying to get midwifery we already have one question here from Lindsay who's asking about the students clinical experience hi Lindsay sorry I need to focus and how is clinical experience for students organised and supervised and we do actually this is the difficult question to explain so we are working as a professor at the university and for example in our school we are eight professor and two instructor and one research assistant and we organise, we are going to the clinics with students and we do all practising with students and it's because of the patient care and the patient safety and it's because of the student safety as well and our students have to be in clinics with our school professor and this is the obligatory in our school and also sometimes we have some arrangements with the midwives and clinical midwives who are working and who has the masters degree and we have really good connection with the midwives and who work in clinic and we do together and our school professor and clinical midwives we do together thanks so much Lindsay, thank you that was one of the questions that I had in my mind as well because getting students lots of experience in the clinical area is so important but you also need to have people who are suitably educated to actually oversee their care and you also need to have all the regulations in place to allow the students to practise so it must be quite difficult are the students expected to get 40 births like they are in the UK? and do they get their 40 births? I need to explain our minimum criteria and at least 40 births minimum 100 prenatal visits with the consultation and actually we do the all criteria from ICM and 40 births and 40 prenatal visits and a piezotomy and 100 postpartum visits like pre-mature post-mature and low birth weight visiting and we do all minimum criteria and we do European Union programme and we do 240 ECTC credits and the good things in Turkish women have children and we have really big hospital very very big two hospital university hospital and state hospital and maybe one day it's going to be 10 or 15 births and it's a good opportunity for our students so do the student midwives who supervises the student midwives while they're doing their 40 births? school professor and okay I need to explain maybe one more in the third year and we are going to the students all professor from the school and the fourth year and last year students are going to be intern intern and they spend one year in the clinic and they have basic lecture in the school and they spend one year like midwives and they have day shift and night shift and they spend one year as an intern and also clinic supervisor and clinic worker and professor working together we have really good relationship with hospital manager hospital doctors hospital nurse and everybody so we can achieve the minimum criteria but for this but the other part of the Turkey and if the change patient profile or demographic features and it's going to be more hard to achieve the criteria yeah yes indeed, have you seen Joy's comment Joy is a member of the Royal College of Midwives here in the UK and I know very well and Joy is great Joy is doing great job for all midwives and I follow her and I admire her yeah I admire her so she's suggesting that she can contact you her if you like for some support in clinical student midwives clinical experiences I'm so happy I'm so happy with the contact Joy maybe you should invite Joy to your international midwifery in other news and I would like to invite all midwives Joy, you and Lindsay, student midwives and we are arranged the next year international student midwifery congress and like 9th of May and I would like to invite you all from Turkey and my hometown and it's going to be really great congress and for students midwives and all international midwives and I would like to invite Joy as well and you so there's another very interesting question there they're asking whether you think that your students are being taught physiological birth or whether it's still very medicalized birth because this is a big problem for many countries in Europe yes, very big complexity and I'm really sorry about that but it's going to be changed because our cesarean section level is so high we are the first I think OECD in OECD countries and after that a policy maker realized and we changed policy and they support normal birth and they support midwives and now, right now and this is the golden time for midwives in Turkey and when we women get the hospital I'm really so sorry but you got induction, we have overmedicalization in Turkey but after this date we are going to be mother friendly hospital I think they start to do some kind of cities and they start to our cities as well and if you get mother friendly hospital they have overmedicalization of midwives but before this time our students try to avoid all medicalization with the women so we teach our school how to the best for women and we teach our school how to be women centered and our students support women and avoid medicalization but in the hospital I'm really sorry but there is some medicalization because of the different kind of reason but after this date maybe it's going to be less and it's going to be more support and more national and labor and it's going to be more happy with women and mother and families and communities and it's very very good you have a long road to journey though every country that I've ever been to and heard about really has had this same journey to make and what we miss often is to teach the basics of encouraging physiological birth like teaching about hormones of birth environment birth that gets missed in favor of in-depth pathophysiology and things sometimes so you are not alone and we wish you every best wish from all of us midwives to change towards physiological birth in Turkey and the midwives being autonomous practitioners that would be great. We need to wind up now though if that's okay fabulous presentation thank you so much we hope to see a lot more of you next year we will meet more Turkish midwives in here maybe in Turkish as we talked before it's going to be great so thanks so much for the fabulous opportunity and thanks so much for all team thank you