Keren Tkach-Maliniak is a medical sociologist working as an independent researcher. Her thesis was written on women’s birth experiences, and her current research projects focus on manners which support and promote the well-being of delivery room staff. She masters quantitative and qualitative methods, and has a diverse research experience, including her positions an analyst on behalf of the OECD and as the manager of a social cognition lab in the academia. Hopefully she will begin her PhD work on healthcare provider-patient communication in the coming weeks. Aside from her research work, she promotes different support projects for midwives.

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Learning what participating in the midwives' B.O.T program means

# The presented work here is a part of a larger research project aiming to identify midwives’ emotional challenges and the how they are addressed. The B.O.T program was used as a case-study.

# A mixed methods approach was used:
Step I: an online survey (n=130), examining the emotional challenges in the work of a midwife and how they are addressed in her   workplace.
Step II: An assessment study was conducted on the B.O.T program, as a case-study, using qualitative tools of observation and interviews at the beginning of the program, and 3 months after.

This research is a case study of a support program for midwives working in hospitals in Israel; an area where support is an emerging need that is not integrated enough in midwives' workplace.

  • A Midwife in Israel works in a highly demanding environment: She is the prime caregiver, providing care to 4 women in single shift. And responsible for 3 delivery rooms at the same time.

  • Midwives find themselves in short and intense interactions requiring intimacy, with no prior familiarity with their patients, and without suitable training regarding communication.

  • Midwives training is primarily focused on clinical practices with little attention to communication skills.

  • The B.O.T program for midwifes stemmed from a growing need in the field for practical tools targeting such unique encounters. The program offers educational and supportive tools for healthcare providers in the field of childbirth for themselves, their colleagues and their patients.

Preliminary Findings

Midwives’ perceived emotional challenges in their work and the how they are addressed

*Most of the institutional support means are local and temporal.

Preliminary Findings

Midwives’ perceived emotional challenges in their work and the how they are addressed

Emotional challenges: a death of a baby, unknown deformities of a baby, medical complications (such as Postpartum Hemorrhage), severe perineal tears, very young women, patients with history of trauma, stillbirth, a birth after a loss, dealing with the family, conflicts between staff members.

*Most of the institutional support means are local and temporal.

Midwives highlighted three core communication elements from the B.O.T Program:

  • Recognition- enabling expressions of all thoughts and feelings (especially the
    unpleasant and contradicting ones).

  • Somatic Awareness- relating to body sensations as an important information

  • Asking Questions Differently- by using 'action' and 'support' questions that recruits
    the patients/colleagues.


New possibilities within the interaction

Strengthening and self-efficacy and self-value

  • Short and simple steps facilitating medical procedures.

  • Practices intertwined with the midwife’s routine work.

  • No aim to resolve psychological and emotional issues.

  • Do not require any special resources.

  • Suitable also for self-help and collegial support.

  • Practices can be implemented in parts or as a whole