Intended for healthcare professionals


Traditional birth attendants are an effective resource

BMJ 2012; 344 doi: (Published 18 January 2012) Cite this as: BMJ 2012;344:e365
  1. Ellen Hodnett, professor
  1. 1Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada, M5T 1P8
  1. ellen.hodnett{at}

Strategies to ensure their training and support in all settings are key

Traditional birth attendants, regardless of how well trained or resourced, are commonly thought to be a poor substitute for care by skilled birth attendants (defined as care providers with professional qualifications, such as doctors, midwives, or nurses) in a healthcare facility. In the linked meta-analysis of studies of deliveries assisted by traditional birth attendants, Wilson and colleagues (doi:10.1136/bmj.d7102) found that offering training, support, and resources—such as clean delivery kits—to traditional birth attendants reduced perinatal and neonatal deaths in low income countries.1 This study provides compelling evidence that trained and supported traditional birth attendants save babies’ lives.

There are enormous economic and logistical barriers to the provision of skilled birth attendants in many countries, especially where women live in remote areas with inadequate transport to healthcare facilities. “Healthcare facility” is a term that encompasses everything from a stand alone birth centre …

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