UMBAL Burgas, the Burgas university hospital, was the only regional hospital to take a scientific and practical part in the 14th International Academy for Midwives in Sofia over the weekend, the hospital said. Its specialists presented two papers: one on natural birth after a previous caesarean section, and one on the conversation between the woman in labour and the team.

Expectant mothers from other cities come to the Burgas hospital because it offers natural birth after a caesarean.

Dr Zlatko Kirovakov, head of the hospital's gynaecology department, presented the first paper. He holds a doctorate in medicine and teaches in the Obstetric and Newborn Care department at the Faculty of Public Health and Health Care at Burgas State University. He and Dr Antonio Dushepeev, who also holds a doctorate, have collected the results of their five-year study on the subject in a monograph.

The study found that natural birth can be a safe and successful alternative to a repeat operation if women are chosen with care, closely monitored and the medical indications are followed.

Dr Kirovakov says medical protocols alone do not produce such results. Much depends on midwives, he says: they stay with the woman in labour, follow the course of the birth and notice any changes. They give her physical and emotional support and encourage her to take part in the birth calmly and with confidence.

The second paper is by Dr Yulia Shapovalova, Stoyanka Nikolova and Dr Zlatko Kirovakov. It is called "Care starts with words – medical communication in midwifery practice". The authors say good communication with the woman in labour is a professional skill and an inseparable part of good midwifery care. It is not just politeness or a personal trait.

Words, the authors say, can calm a woman in labour and help her understand what is happening to her. That lets her make an informed decision and work with the team. The same words can also cause fear, distrust and a sense of helplessness, even when medics act correctly. The authors therefore say the skill of talking with women in labour should be taught, practised and assessed like any other professional skill.

The hospital says the two papers share one idea: a successful birth is not only a medical result but also an experience in which the woman feels safe, informed and supported. In both papers the midwife has a big role, and her knowledge, skills, attention and attitude to the woman in labour are part of the team's success.

Midwives, doctors and other specialists took part in the forum. Its motto was "Together for women's health with science, care and dedication".