Information exchange among ICM board members--challenges and opportunities: at the June 2006 Board meeting in The Hague, members were asked to report three current midwifery issues from their region and to tell one 'success story'.

• Tenlastelegging: International Confederation of Midwives

Andrea Stiefel (for Central Europe):

* There is a drive to raise awareness among both the public and government of unnecessary medical interventions

* There is a current need to protect distinct midwifery education for midwives' autonomous practice in any setting (there are problems particularly in the Czech Republic)

* Effective legislation and regulation is essential.

The success story is that a good meeting has already been held in the newly formed region, with new members attending, and she feels that trust and confidence in ICM is being further built up. A draft action plan is in place.

Judith Chamisa (for Africa East)

Judith drew the Board's attention also to the written report she had submitted.

* A number of well attended workshops have taken place in the region, including those organised by POPPHI, by UNFPA and by ICM and partners on HIV training

* As regards increasing membership of ICM, she feels there is often keen interest shown when she talks with representatives at meetings but less enthusiasm when there is later follow-up. However, the Mozambique midwives have submitted an application

* The migration of midwives away from African countries is a very serious issue and the lack of human resources is threatening women's lives.

A recent success in Zimbabwe has been the creation of the women's and midwives' partnership organisation called For Love Of Women--FLOW.

Debrah Lewis (for the Americas Region)

* There is a continuing challenge of attracting and retaining midwives as members of associations, and ensuring that tees are paid

* Midwifery education is not always of good quality and is sometimes carried out by non-midwives

* A future workshop is planned to provide an intensive update for midwives.

Successes include enhanced networking among the American College of Nurse Midwives, the Canadian Association of Midwives and the associations from Jamaica and Barbados. Haiti and Surinam have successfully applied for membership. Midwives in the Bahamas are forming an association.

Vitor Varela (for southern Europe)

* Vitor felt the need to gain some experience and advice from other Board members before taking effective action--he welcomed the chance to learn at this meeting

* As elsewhere in Europe, there are concerns about high intervention rates, e.g. the CS rate in Portugal is 30-35%

* He has been in contact with the associations in Cyprus and Cape Verde, but communications are not easy with all associations. The Lebanese...