Ep 84 Sandra Mutilva on Innovation and Leadership in Midwifery and AI

Ep 84 (ibit.ly/Re5V)  Sandra Mutilva on Innovation and Leadership in Midwifery and AI 

@PhDMidwives   #research #midwifery #AI #innovation #healthcare #governance @world_midwives @researchTMU @AdlerUniversity #artificialintelligence #poorwomenshealthdata

 https://linktr.ee/drsandramutilva

What happens when the passion for midwifery meets the power of technology? Join us as Sandra Mutilva, a remarkable midwife who journeyed from Argentina to Canada, shares her inspiring story. Growing up in a large family in Argentina, Sandra was captivated by the wonders of childbirth, leading her to pursue midwifery despite her parents' hesitations. Her path took a transformative turn when she immigrated to Canada, navigating a new healthcare landscape and establishing a successful practice through perseverance and a bridging program.

Sandra's story is not just one of personal triumph but also of innovation in healthcare. As the chapter unfolds, she discusses venturing into leadership roles and pursuing an executive MBA, ultimately leading to PhD research at the intersection of technology and women's health. Sandra uncovers significant biases in clinical trials, shedding light on the gaps in women's health data and the critical need for equitable research funding. Her insights urge midwives to become advocates for fair technology development and access, positioning themselves as leaders of change in the digital age.

Amidst the challenges of a global pandemic, Sandra's academic journey became a testament to resilience and adaptability. She opens up about balancing rigorous PhD work with family responsibilities and financial constraints, finding strength in a supportive network and the guidance of her dissertation chair. As we explore Sandra's unique perspective on the evolving role of midwives in AI and data protection, her story becomes a call to action for midwives to embrace innovation while upholding their tradition as guardians of childbirth.

Transcript

Journey From Argentina to Canadian Midwifery

Speaker 1 0:27

Thank you very much for joining me, as per usual. Can you introduce yourself, please?

Speaker 2 0:33

Yes, my name is Sandra Mutilva. I am in Ottawa, Canada, and before we proceed further, I would like to begin by acknowledging the land that I am. That is a traditional unceded territory of the Algonquin and Anishinaabe people. These people have lived in this land since time immemorial, so I am grateful to have the opportunity to meet you and your audience in this territory.

Speaker 1 1:04

Thank you, and I acknowledge that I am on Kaurna land who are traditional owners and live on the lands here, and they have been birthing on these lands for 60-plus thousand years. So we owe a lot to our Indigenous ancestors and forebearers for a lot of the knowledge that we have as well. Yes, so let's start at the very beginning. How did you get into Midwifery?

Speaker 2 1:39

So it was family related, um, so my, my mother had 12 siblings. Um, of those, uh, she had seven, seven sisters, and my dad have eight siblings. So I am originally from Argentina, right, and my dad have eight siblings, were three sisters. So during all this, you know, family gathering, christmas parties there were lots of women around as I was a little kid, and always they were pregnant or somebody was breastfeeding a baby or, you know, somebody was in labor. And also, I live in a community in a semi-rural area where, you know, it was always somebody was pregnant. So I think that those aspects generated some curiosity for me.

Speaker 2 2:34

And when I finished high school, I did very, very well in school. So when I was, you know, assessed for the kind of career that I wanted to to do, you know, this assessor said she should be in science, economics, engineering. But walking in the street I found a former classmate. We were in a sport together. She was senior than mine. So she, she told me that she was going to a school and studying midwifery and this is something that, um, I didn't, I didn't know much. And then she described to me about, you know, what she was learning.

Speaker 2 3:26

So, and because I have that seed in me related to curiosity about women's health, pregnancy. So I went to you know, I remember that I told my parents and they were not quite happy with that choice. They wanted me to become probably a physician or an economist, but anyway, they understood. So and there everything started. I, I, I started me with a school, being very young, um, at the university universidad nacional de la plata, which is uh, and it's the school of me wayfaring, that has been there for a long, long time. So, yeah, this is a little bit of the story. How?

Speaker 2 4:18

long was the course, how long it was four years of midwifery, so it was health science. The good thing about that, what I found that it was great, is that the midwifery school was in the in the main campus and it was close to the faculty of medicine. So there were some courses that we did with the medical students, like, for example, anatomy, physiology. You know, all these hard science courses we did in combination so that created the opportunity to learn each other and I learned a lot from the medical students and they learned a lot from me midwifery students. We had the opportunity also, because I was always involved in sports, to do some, you know, explore activities as part of the same team, and so that created lots of good opportunity to network, to learn from each other. So then when you get into practice there is not this tension, that in midwifery versus medicine that you know I have experience in other locations.

Speaker 1 5:42

So was that a nurse midwife or a midwife only?

Speaker 2 5:44

qualification no it's a direct entry midwifery. So you graduated with a degree in midwifery. So you graduated with a with a degree in midwifery. And then once you graduate, you don't go to practice right away. You have to do a three years residency between three and five years depends how you perform and you work in the community doing community health, uh, and you also work in hospitals and I did my residency in three, three years. So during this training, because you know they are it's a developing country at that point when I did the the course and you know people died in childbirth. So you have to have very hardcore clinical skills because you can't get into any clinical situation. So you have to be very well prepared and very well versed in clinical knowledge.

Speaker 1 6:53

How did you build up your resilience to that? Was it just exposure to this is the way midwifery is in Argentina, or was there other things that you did to increase your resilience, to be able to survive in that situation?

Speaker 2 7:07

I think it was mainly teamwork. So, because you are part of a big team, it's a team effort. So, for example, I did shift work but also work in the community. So when you do shift work you are surrounded by nurses, by physicians, by colleagues, other residents, students. So there is a big team and also, you know, teamwork helps you with those aspects of when you know you go through a case that could be traumatic, like you know, losing a patient. So, yes, I think that for me during those years, for me it was the team support, team and family support.

Speaker 1 8:04

Yeah, so what made the move, then, from Argentina to Canada?

Speaker 2 8:10

So I immigrated to Canada in 2003 and 2004. Argentina went through a really bad political and economical instability and I remember that I was young but anyway, I lost my savings, like many other people in the country, and it was a hard moment and so I wanted a change. I wanted a change so I decided to explore another horizon. So Canada at that point was opened for foreigner trained midwives. There was a program, a bridging program, designed for foreign trained midwives, which I was accepted. So I entered into the country with a visa and then, once I had a permanent residency, I could apply and because of the clinical exposure I had being a midwife in Argentina, that bridge program was really. I did it very fast, yeah and um.

Speaker 2 9:35

So this is because of the volume an average midwife I don't know how would be in australia, but an average midwife in argentina delivers close to 400 babies a year. Wow, yes. So, plus the different aspects of the social exposure, clinical work, the scope is quite wide. So the clinical aspect of becoming a different system you know the language, but then when I was immersed into the profession, I did very, very well. I became, I founded my own practice here with other colleagues here in Ottawa and we developed a nice practice in the community. I also was the chief of midwifery at the Ottawa Hospital for several years and I had other leadership positions involving different community leadership teams in healthcare. So yes, and so it was great yes, a good move.

Speaker 1 11:02

What did you find about the differences between Argentinian midwifery and Canadian midwifery?

Speaker 2 11:15

Argentinian midwifery and Canadian midwifery, yes. So I think that the Argentinian model and I don't know if you have been interacting with midwives who are working in developing countries are obligating you to kind of medicalise the process because you know what you know. Sometimes they they said, okay, maybe a pph, a pph in a to say, evaluate that. You know the blood lost. You can say 500 milliliters, but this is in a healthy client, in a healthy. So in some places, five milliliters of blood loss in a patient, you, you might lose that. That that client so obligates you to think ahead, uh, obligated you to to manage risk in a completely different way. So that's why I think that it could be more medicalized and with the tendency to be more risk, not adverse, but prepared, yeah, yeah, and here you know there is the Canadian model has a philosophy behind yeah, to form midwifery. So you have to provide informed choice, choice of birthplace, continuity of care.

Exploring Midwifery, Leadership, and AI

Speaker 2 12:45

Where I was from that didn't exist and so they are good. So I enjoyed both models. In one of them, in Argentina, I feel like you know, my clinical knowledge was quite necessary and appreciated. Here there is also another qualitative aspect that is also very, very important to perform well, that might not be required. Maybe you know in other settings.

Speaker 1 13:22

And in French, midwife is such femme.

Speaker 2 13:27

Yes, such femme.

Speaker 1 13:29

Such femme that's wise woman. Yes, so even the name has a different kind of it, brings up a different perception. Yes, what midwifery my language, my.

Speaker 2 13:41

You know I am argentinian so we speak spanish. So the the title of uh of a midwife there is partera dance. You know, parto is childbirth, so partera is is kind of um, the, it's kind of the word where the profession is being, is being called there are other. There are other um names in latin america, like matrona, comadadrona, obstetrica, obstetris. Yeah, so yes, in French it's asphalm.

Speaker 1 14:21

You know, in English it's midwifery with women. So you've done quite a lot within, as you said, within Canada. You kind of were able to establish quite well and start a practice and also then kind of work up. How did that then kind of help with you developing your studies and then expanding your qualifications, because you've done kind of a little bit of a different pathway to what majority of midwives, which is kind of going to be really interesting to talk about. So what set you on that kind of post-grad pathway?

Speaker 2 14:50

Yeah. So when one of the things that I noticed that I had natural leadership I don't know how to define, but characteristics so I always was involved in sensing, you know, since I was a student in school, when I was a midwife, I was in the you know, a student council. I was also doing sports and involved in the sport activities of the university. Here I also was a business partner in my practice, chief of midwifery, deputy chief, and so I wanted to get the hard aspect of leadership right. I wanted to learn more about how to, because there is also an entrepreneurship aspect of my, my, my, life, um, so I wanted to do, um, I wanted to learn those things how to write a business plan, how to talk to an investor, how to support another entrepreneur, especially women entrepreneurs. So I went to a school and I acquired the executive MBA at the University of Ottawa. So this is a hard degree for someone who doesn't have any kind of business, accounting, financial background. But anyway, I navigated quite well. So I got my MBA, executive MBA, and then, when the pandemic hit, I was doing some consulting work. So my business went kind of, you know, decreased. So I said, and now what, what am I going to do and then I decided to start my phd. And I started my phd in so I said, okay, maybe epidemiology, something related with science. But then, as I was reflected in my, in my, in my path, I said, you know, there are lots of scientists in this world, but we need more leaders. So how, what they can do in order to develop leaders, to support, to support women in leadership. So I decided to do my phd in organizational leadership. So I was accepted and I did it in the usa and so I was accepting.

Speaker 2 17:39

In school I went through my PhD studies, which was quite fascinating. You know learning about leadership characteristics, learning about leadership attributes and doing some coursework. You know writing about it. I learned a lot about leadership. And then, during my dissertation, I always liked technology. You know being an entrepreneur.

Speaker 2 18:13

So one of the things that intrigued me was during the COVID, something happened that, all of a sudden, technology that was there in the pipeline might have been taking years and years to develop. It happened like this and you know people were doing virtual care and you know developing vaccines super fast, super quickly, and you know the pharma and all that using technology. And so I was reading about that and I was reading about all that using technology. And so I was reading about that and I was reading about AI, artificial intelligence, and how that was going to be applied. And then one of the things that, as I was reading about it, I found that the base of the pyramid of AI was data, right, so this is what defines a strong or weak AI.

Speaker 2 19:15

So, because I have this knowledge in women's health, I said, okay, we are applying all these AI systems in devices, in systems that are applying to women. But if we go back, you know that, as a scientist, that most of these clinical trials, most of the research, has been done in male subjects, and so how the reliability of data is in those systems, you know, applicable for women. And this is how I started to generate my hypothesis and I said, okay, maybe this could be a good study. So I say you start. So I got really, really immersed in it and and say, okay, I'm going to start capturing this reliability thing. Or you know perceptions in leaders of in AI application for women health, and what did you?

Speaker 1 20:32

find.

Speaker 2 20:34

So I found that you know I was right. So I was able to survey because my study was mainly quantitative, and the reason that I choose a quantitative you know there is also a qualitative, but it's mainly quantitative it's because the tech industry speaks. You know numbers. So if I have to, you know when I talk to somebody who is in technology, it's going to be maybe easier to present the findings in numerical data. Engineers, obgyn, that understand about women, health and AI, and there were also a few midwives not many, because I think that this is something that maybe we can talk later about midwifery and AI. So, and yes, there is something that as they were going through the survey, then the feedback I got is that they reflected on that to say, okay, you know, we are applying these systems, algorithms and without taking into consideration historical data in women's health and also the funding in research.

Speaker 2 22:11

I don't know how is the funding of research in Australia, but here in Canada, the big portfolio of research, the money going to women-specific health conditions, is not there, apart of from oncology. Oncology, yes, research, you know, is there is lots of funding there, but in things that are specific for women, that could be cardiovascular disease that we know that affects women differently. Menopause is like a big, big black hole. Absolutely and you know this is my other I use menopause as a it's part of my social responsibility as a scientist and as a scholar. I do lots of talks about going from childbirth. Right now I am talking about menopause and so the lack of innovation in women's health.

Speaker 1 23:14

There are some devices that might not be adapted to women to detect conditions, and I think that that requires requires awareness, especially for midwives, in how these algorithms are being applied in pregnant people and any women, and I think I read somewhere that I think one of the comments you made in a previous interview that you did was that and I really liked it that we need more female engineers and technicians to actually think about what we need and the tests and the machinery and to actually come from it.

Speaker 1 23:58

Um, from a female perspective, and because I think about things differently. Even if there are scientists, their brains are still thinking about things differently. Even if they're a scientist, their brains are still thinking about things differently, and I really like that idea of having more females, because we are 51% of the population do not recognise as being male and do not have the physical structures and the biological structures of being male. Yet everything is and has been. This world is a male-created world and a white male-created world as well. So when you're thinking about the diversity that's in the world, that's not also taken into consideration in the data either.

Speaker 2 24:36

Exactly so. They are not, for example, women in STEM. You know, science, technology, engineering, mathematics. We need to start having more female presence in science because there are studies done that show that when there is a female show that when there is a female but female investigator or author in some of those studies in technology, even the language change. So we need more biomedical engineers, we need more that are females, we need more engineers that are females and of course, you know for us, for midwives, that we are some kind of guardians of the normality of, you know, women. We need to start being involved and more aware about this technology. I don't know how it's in Australia, but I didn't find one. You know I teach and I didn't find one single school in midwifery that had artificial intelligence, design of courses for midwives.

Speaker 1 26:09

I think it's in small things, like we've just introduced, or we're not just, but we're slowly increasing the use of Microsoft Copilot. Yes, because once again it's about the accessibility of data. So we can use microsoft co-pilot because they put it behind the university um uh firewall. So, yes, we can drag information from outside. It doesn't put our information outside to the general population. So we've got that bit of IP security and so we're slowly trying to in between day-to-day crush of trying to develop a course, trying to learn how to do that as well.

Speaker 1 26:54

The other thing that's really interesting at the moment in Australia is our National Health Research Ethics Body is having a discussion about the use of gender and the identification of gender in research, and it's a really interesting discussion because there's a group of prominent midwifery leaders who are fighting for the continued inclusion of gender categories because of that exact thing is that women's health is so poorly represented and if we don't have um gender identities and even if, is it gender identified at birth versus um individually recognized gender, if you don't have those categories, then we are going to miss out on so much data that is going to influence the health care of women and and people who don't identify as as male in future research, and that data is actually critical because we do have changes. We do have biological changes that need to be taken into consideration, which is why, as you said, most research is done between the ages of males on 18 to 60.

Speaker 2 28:09

Yes, so also, you know it's very important to capture in the data the difference between sex and gender, because they are not the same thing.

Speaker 2 28:20

So this is also very, very important. To determine that make the difference how an algorithm can perform in an individual. Yeah, especially so, for what I am seeing is that it would be great if midwives because you don't need to be necessarily involved in the technical aspect but, as you mentioned, the aspect of ethical and governance in AI midwives can have a very good, a great participation in that. And also, if you own your practice and you are exploring about certain, including certain devices or systems, you will need to talk to the vendor to say tell me about the training data of this system or of this device, and you need to be prepared to challenge and also, when we go to hospitals and some of those systems are being applied, how they can perform in midwifery right, there's an application that I've seen some advertising for, and it's an AI medical assistant, and so, basically, it will write the notes for you while you have a discussion with your client, and then it does the summary.

Navigating the Challenges of a PhD

Speaker 2 29:56

Yes, genea TVI does that and yes, that is one of the main uses of Gen AI right now in healthcare. There are no generations and that would be great because I remember when I was in practice the time that I spent reviewing notes and doing my clinic sometimes finish at 5, but I was probably up to 7.30 in the evening writing, reviewing notes, making phone calls to make sure that I capture everything in those visits. So if you have some kind of AI assistant that is doing that for you, that will increase your awareness about what is happening with your client and during quality contact time as well, because actually talking and looking at them and talking to them, and not with your head down just kind of nodding.

Speaker 1 30:59

What surprised you about your phd results?

Speaker 2 31:06

I think it was not the surprise, it was the process, you know, the whole process is what surprised me is how things were unfolding. And you know, because when we formulate a hypothesis, I said, oh yeah, I am going to be interviewing these people who are really fan of AI. They will probably will be challenging my, my survey, or they will come to say, well, you know, we are trying to demonstrate. And then it was the opposite. It's like, you know, the feedback I was, you know, receiving from these people who I was surveying was, oh my God, that is really interesting, this perspective. So you know how funding in research can influence the performance of AI. You know they never, they didn't think it that way. So yeah, and also how hard it was. What is the surprise that I had in, you know, doing my PhD?

Speaker 1 32:25

How did you balance that? Well, did you balance it between work and, because you're saying, it happened around COVID time, so your work had decreased a little bit. So did you set up a structure for your study? Were you full-time or part-time?

Speaker 2 32:40

No, it was full-time. So, and there the financial was really critical because I was not working full-time. Financial was really critical because I was not working full time. But you know, I got a scholarship and so that helped to pay the tuition. Tuition in the USA are extremely expensive, yeah, and so it helped with that. I was doing some work and teaching and so because I am, I am, I am single here in this country and you know I so it was I didn't have all my family's in Argentina, in Latin America, so so I also helped from friends and was. You know, I have some sponsors, some heart sponsors, people that help me from the heart.

Speaker 2 33:42

And yes, it was quite challenging because your life gets in standby during those three years, you know you cannot have summer vacation because you have to work in your research and then you have to be prepared to meet with your advisor.

Speaker 1 34:03

But did you do that online because you were in Canada and they were in Chicago?

Speaker 2 34:07

Yes, I did that, but I also needed to, and they were in Chicago. Yes, I did that, but I also needed to do some things in Chicago too. Yeah, but you know I had my. You know you have to always be prepared because you are accountable to yours mainly to yourself. I wanted to finish as soon as possible and so I was dedicated and yeah, it was like eight hours or nine hours sitting, you know, on my day chair and writing, and yeah, it was. You know it's a hard process. It was quite different than what it was when I did my MBA. The MBA feels more like a spring, you know, run faster, but here it was like a marathon, you know it feels like a marathon. It feels like every day you wake up, you organise your day, you say, okay, I'm going to probably write two paragraphs today about this, you know, focusing in this aspect. And on top of that there is some coursework that I needed to do. And yeah it was so.

Speaker 1 35:28

How did you keep your mental health like? Were there times where you just wanted to give it up and go rock and cry in the corner? How did you keep that strong so you could finish?

Speaker 2 35:39

because not everyone does I didn't have those moments right. I didn't have the because I was very focused the only thing that I maybe because I have been in a sport and so I was focused on the end line, so I didn't allow myself to get into those moments right. You know, when I was doubting or things like that, I was saying no, you know I was doubting. Or since, like, I was saying no, you know I am, I am doing this at this age, at this stage of my life, I have to finish. There is no, no way around. Um, but you know, it's starting to hit me, maybe more now, because I, right now, I I am a little bit tired, but during that time, sometimes I was trying to find a way. I don't know if I mentioned a good supervisor.

Speaker 1 36:40

Yeah.

Speaker 2 36:48

But when I was saying, okay, you know I don't know how to use this software to analyze data, you know which kind of methodology I should be doing. I need more participants to run a regression. And da, da, da, da, and you know, she was really, really good in terms of saying, okay, try this, try that. If I'm going to connect you with dr such and such, who is very good at um, you know, this kind of methodology is going to mentor you or give you for a, you know, tutor session, um, things like that. So I think that it all depends in your advice.

Speaker 1 37:28

But did you pick her or was she allocated to you when you got the offer?

Speaker 2 37:36

Oh, that was something. You know. Sometimes things happen for a reason. When I started the dissertation course or the dissertation time after I did the comprehensive exam, comprehensive exams were something. Oh my gosh. Those moments, yes, they were probably the most stressful ones, my comprehensives.

Speaker 2 38:20

But then, when I did the. So I interviewed several professors that they were available to do to be dissertation chairs, and I found one professor who was in Florida, he understood technology very well. He got my study like that and you know, everything was ready to go and I was really. He was taking also three more students from my kind of cohort and we all were very happy with him because he seemed to be very understanding technology very well. But then after one month of working with him he had a burnout. So I interviewed several chairs or prospects and I said so.

Speaker 2 39:15

I talked to the director and the director said okay, there is no choice right now. We are going to allocate the chair for your and it's going to be Dr Masorowski and she's the director of the Applied Psychology program. We know that you are doing a quantitative study. She understands quantitative research, so you know, and she was perfect. So I was really really disappointed. But then it worked really well at the end because, um, if that professor would have continuous, you know, with working with me, maybe what happened is he gets this uh kind of situation when we were advanced, very advanced, yeah, during the dissertation. That would have been really, really hard.

Speaker 1 40:12

So much easier to change earlier on than it is later on. Absolutely, yeah, okay, the important question how did you celebrate?

Speaker 2 40:23

um, so after I we did a, after I did the PhD, I had my celebration with my neighbors. Okay, because they were. All my family is in Argentina, so I haven't had the opportunity yet to travel, but you know I am planning to go there soon and celebrate there my certificate. But you know I celebrate with my certificate, my certificate and um, but you know I celebrate with my neighbors and and friends, uh, who were there. So we had a, a nice meal and and drinks at my place and, yeah, it was, it was really fun. Plus, you know all my network. Um, I seen that they did my PhD with me.

Speaker 1 41:10

Absolutely, it takes a team.

Speaker 2 41:11

It takes a village. It takes a village, my network. They were always asking me how things are going, how we can help you People, sometimes the new leaders in technology, they were introducing me to them so I could survey them or, you know, making a connection.

Speaker 1 41:41

So, yes, it was quite good yeah, and it's important for people to remember that midwifery is more than kind of being on the floor catching babies.

Midwifery, Technology, and Leadership in Canada

Speaker 1 41:52

And if you look back to the State of the World Midwifery Report 2021, they've got four areas of focus that need to happen. So it's not just clinical service, but it's also leadership and governance, it's education and it's kind of workforce and research as well. But we need that leadership because if we're not at the table where the conversations are happening and if we don't know how to talk to the people who are making the decisions, then we're going to continue the way we are, we're not going to be able to change within the healthcare system and it needs that organizational change, because we all know that you can do the best thing that you can do, but if you're in an organization or in a structure that isn't working and most of healthcare around the world is not working as well as it could because it's under so much pressure that, yeah, you have to have that leadership and governance. So it is a critical area that we need midwives in.

Speaker 2 42:51

Yeah, that's why I did my PhD in organizational leadership. I said you know, maybe there are lots of midwives who are excellent in epidemiology research, but there is a huge gap. I don't know how it is in Australia, but here in Canada we are starting to, maybe because I did my leadership studies, um, but it's becoming very, very evident, especially to lead innovation. Because when we talk about leading innovation, we're thinking technology and it's not. The innovation is not about technology only. It's about change systems, bring ideas forward, how you can change you know how we traditionally are doing things and we need the presence of midwifery. Midwife needs to be more present in that.

Speaker 2 43:50

I don't know, but I am not seeing midwives in executive positions, in the C-suite of hospitals or VPs. There are not many here in Canada. We need midwives who are politicians, who can be in parliament, who can be in a congress, who can be senators, you know, and this political presence is not there and that is starting to concern me because if, especially right now, how fast the changes are happening because of technology, because of AI, if midwives need to start doing a movement now, we're lucky one of our federal members is a midwife oh that's good, and so it's been really great for her.

Speaker 1 44:47

And we've got a couple of state midwives, and I think maybe a federal that were nurses. So we've got a couple of people who are representing and are standing up. But yeah, having a federal member who is a midwife was really kind of fabulous to see and she has stood up and she's kind of been very vocal when the situations come through, which has been great. No-transcript.

Speaker 2 45:16

I think that right now, I am starting to be more required to bring this perspective of AI in women's health. I you know I haven't seen any you know, tangible change yet, but right now, the fact that people are consulting to me midwives, they want to talk to me about this, they want me to do webinars and educational sessions about is a way of change. So, and also I am involved as a consultant in some activities where I also bring in this perspective and about how important is the diversity in data to have a, you know, good performance in AI.

Speaker 1 46:20

Where do you see AI in midwifery?

Speaker 2 46:25

So I see that it's going to help in education definitely, probably with for example, I was a foreigner-trained midwife. It would be great to have, maybe and it was kind of shocking for me when I was exposed to an OR here in Canada versus the OR in Argentina or in other areas, or a hospital in Argentina versus here. So maybe it's to do virtual reality, augmented reality, to create those scenarios. So when you as a foreigner trained practitioner not even as a foreign, maybe as a student so you get exposed to those scenarios so you know what to expect when you get into a facility, a healthcare facility like a hospital Simulation in technology that use AI, like you said, use Gen AI to help with some admin tasks.

Speaker 2 47:36

In future, maybe to have lots of companies out there that are developing robots Not in the form, you know a robot is not in the form, that like we are thinking about being this humanoid presence, but there are other kind of robots and those robots need to be programmed to interact with different clinicians. Yeah, so who is going to be bringing the perspective of midwifery? So a midwife in a labor and delivery can have a robot assistant that maybe can help to bring a warm blanket for a client. I remember when I was working I needed to leave the room or ask a nurse to say, can you please bring a warm blanket or ice for this client? And probably, you know, a midwife might be working with a robot that can perform that task or those tasks. So that might sound dystopic, but they are there Well they're already created for different things.

Speaker 1 48:44

Yeah, so it's not that far away from being reality in a lot of areas.

Speaker 2 48:50

It's going to be and it's going to happen soon. So you know, this is how I see you know being this kind of help. It was also, for example, maven Clinic in New York had an AI doula and that helped people in labor with support people in labor with support and it was it decreased by 26 percent interventions. Oh wow, especially in russia, like the russia lies population who could not afford to have a doula. So this doula was working with a laboring client to say, okay, are you in emergency? It was basically it was an AI assistant to say asking questions to the labouring person and it helped to decrease intervention. So imagine if that could be applicable also for midwifery client. That might also decrease the amount of of visits done to the ER. You know, if you have this kind of assistance during during your work, I remember being a many, many times during the night to do an assessment to a client and they were not in labour. So maybe those things can help to increase the quality of life.

Speaker 1 50:31

Which helps with justice and equality. But then, on the other side of equality is you've got to make sure that everyone has access to the devices where they can actually use the technology. So some people can't afford the latest smartphone, so therefore, how do they and that's that bigger. I think that broader image too is we can have all this technology. That is going to be great and is going to allow people, without having to pay for this service, to have an equal level of service. But then, physically, can they access the technology?

Speaker 2 51:07

Yes, I agree, there is also the technical divide. So this gap in access to technology that also Midwest can advocate right is the digital divide. Yes, it's that some people don't have access to technology, but in the other cases, some people who are living in isolation or in isolated places, if there is good technology they can access a provider, they can access care. I don't know how it's australia, but here in canada there are communities that are still being a people that are pregnant need to leave their communities at the end of the pregnancy to so there is maybe access to technology that could also be decreased.

Speaker 1 52:03

Yeah, we're doing increasingly more telehealth in remote areas, but there's still, yeah, women and pregnant people still have to leave if they've got any complications, and they have to leave a month earlier for birthing and birth, basically off country, off their own country. One of the big issues with AI and you probably won't be able to give me an answer is the security. How do we, if we are going to go this line, how do we keep that information secure? So Taylor and Francis it's a major publication of journals they have given agreement to all of their publications are now able to be mined the data for AI development and growth. Now they've done that without talking to any of the authors, so we no longer have that option of opting out because, well, as you said, you've got to have the data. Without data, ai won't grow. But how do we keep that data secure when it is actually being used?

Leveraging AI in Midwifery Data Protection

Speaker 2 53:07

Yeah, so this is cybersecurity and that's why it's very important the governance aspect of the data management, and so regulatory bodies need to be aware of that because this is part of the you know boards in hospitals. They need to understand about that because this is part of their fiduciary obligations. It's about, you know, the protection of the data. So that is an aspect of governance. And right now, regulations there is patchwork in regulation. Europe is doing a better job in terms of regulation, but in North America there is still some patchwork here and there, and it will require definitely a governance aspect and also involvement, professional involvement. You know, this is how probably midwives can be also advocating about that how we protect the data of our clients in terms of interoperability and all those aspects that technology has, and that's why you know it's important to be involved.

Speaker 1 54:35

Especially when you've got to keep midwifery records for anyone from 21 to 30 years, depending on the country law. That stuff has to be taken into consideration.

Speaker 2 54:45

Yeah, there is lots of data out there. However, not all the data is being used. And also that is something important because right now, with Gen AI, midwives can leverage historical data about midwifery performance that could be applied even to challenge the current evidence models.

Speaker 1 55:12

So lots of possibilities. No matter what we think about AI, it is here and it is going to become.

Speaker 2 55:20

It's not going anywhere.

Speaker 1 55:21

It's going to become more pervasive in every area of our lives and we have to work out how to work with it.

Speaker 2 55:31

How to work with it and how we can be involved in aspects that are still really like you mentioned cybersecurity, in aspects that are still really like you mentioned cybersecurity, equity of the data applications and I think that this is a great opportunity for midwives to bring their perspective and to be. We have been guardians of the normal childbirth, so right now we can be guardians of the application of AI and the data.

Speaker 1 56:03

Oh, that's perfect. Yeah, thank you so much for your time.

Speaker 2 56:09

My pleasure, so I hope I answered all your questions, absolutely.