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Soapbox Chief Scientific Adviser, Professor Wendy Graham reports from her latest conference attendance in Brighton…

On July 19th, I boarded another train – but not to Aberdeen or London to meet the rest of the Soapbox team, nor to an airport – as per usual. Today I was going to the Student Midwives’ Conference at the University of Brighton. I had been approached to speak several months ago and now the day was here. The title of the conference was Empowering Midwives, Empowering Women – and I was invited to talk on whatever I chose, although I knew the organizers were interested in the Lancet 2016 Maternal Series. So the challenge was how to combine some of the key messages in the Series with the mission messages from Soapbox.

The train journey was uneventful, albeit hot with the outside temperature as we passed through London of 28 degrees. The breeze from the sea at Brighton was a welcome relief, the road traffic was not. The site of the conference was close to the Brighton and Sussex Medical School, and I eventually reached the throng of over 50 student midwives – during their coffee break. Two things were striking: they were all women, and they were all in lively conversation – with much comradery in the air. This is a stereotype, I know. Male midwives are very common in some parts of the world where Soapbox works, such as Ethiopia, and at times the stresses and the strains of the daily challenges of providing quality care to women during childbirth mean that spirits are not lively and teamwork breaks down. But in this venue, I savoured the moment of palpable positivity and joined-up thinking and working.

The next speaker was Kathryn Gutteridge, the President of the Royal College of Midwives (RCM), who shared her wealth of experience of – as she called it – “serving women”. Kathryn stirred the audience – mostly of student midwives and also qualified midwifery practitioners, advocates from NGOs, and a few hardy medics. Towards the end of her presentation, Kathryn returned to the theme of the conference – Empowering Midwives, Empowering Women – with a phrase urging this future generation of midwives to accept and practice their role in representing the voices of women. And in that moment, I found the parting message for my own presentation.

During my 30+ years of speaking on maternal health, I have always been a last minute preparer! Some of this is simply too many other things to do, and some is my natural edge-walker tendencies – needing a deadline to force me to create the presentation. But I also rely on the “spur of the moment” to help me craft the final message. So thank you, Kathryn – and the conference organisers – for creating that moment.

And the subject of my talk – and the final words? The overall title was “Leaving no one behind: clean birth for every mother and newborn.” For this predominantly UK audience, I wanted to remind them of the first phrase from Ban Ki Moon, former United Nations Secretary General, who spoke these words to emphasise the essential need for equity and equality. And the second part of my title was to raise awareness of a basic human right – clean birth – which is still denied to both thousands of women every day and to the midwives who attend them in institutions throughout the world, and particularly in LMICs. The talk introduced the 6 elements of what I call the Perfect Storm for Infections – with reference also to the role of George Clooney in the original Perfect Storm film from the year 2000, for which the term is perhaps best remembered! The 6 elements aligning, in my view, to whip-up a maelstrom of preventable infections in mothers and babies delivering in maternity units are: 1. the changing risk profile of women delivering, 2. the increasing proportion of deliveries in institutions, 3. the poor state of water & sanitation in facilities, 4. the gaps in routine infection prevention and control, 5. the weak health record systems and surveillance of maternal and newborn infections, and 6. the emergence of antibiotic resistance. All elements were highlighted in the 2016 Lancet Maternal Health Series, but not as a “storm”.  These are indeed a dramatic set of contributing factors – just like in a weather system and a perfect storm. And like a storm, they can be dissipated and ameliorated in terms of their impact. This is the main mission of Soapbox.

But we need more voices for this message. Clean birth is right, a need and a desire for every mother and newborn, and also an expectation that most providers of quality care to women in labour hope they can provide.  This is where the connection to the RCM President’s address provided my final words: Midwives can and should be one of the loudest voices for clean birth and the voice of women around the world. And judging from the enthusiasm and passion for “serving women” apparent at the conference, I think there will be no need to worry about the volume of this message. At Soapbox, we look forward to playing our part in “zero tolerance of unclean birth – leaving no one behind”.

But the last word on this page is to admit that is my first ever blog! So a big thanks to our Soapbox communications officer – Joanna – who has nudged me into this century!