Traditional birth attendant
Encyclopedia
A traditional birth attendant (TBA), also known as a traditional midwife, community midwife or lay midwife, is a pregnancy
and childbirth
care provider. Traditional birth attendants provide the majority of primary maternity care in many developing countries
, and may function within specific communities in developed countries
.
Traditional midwives provide basic health
care, support and advice during and after pregnancy and childbirth, based primarily on experience and knowledge acquired informally through the traditions and practices of the communities where they originated. They usually work in rural, remote and other medically underserved areas. TBAs do not receive formal education and training in health care
provision, and there are no specific professional requisites
such as certification or licensure. They often learn their trade through apprenticeship
or are self-taught; in many communities one of the criteria for being accepted as a TBA by clients is experience as a mother
. Many traditional midwives are also herbalists
, or other traditional healers. They may or may not be integrated in the formal health care system
. They sometimes serve as a bridge between the community and the formal health system, and may accompany women to health facilities for delivery.
who respond to requests for service. The focus of their work is to assist women during delivery and immediately post-partum. Frequently their assistance includes helping with household chores.
However, TBAa have no modern training on how to attend pregnant women, including how to recognize and respond appropriately to complications of pregnancy
. For this reason, the way many attended the delivery was risky for women and their babies, leading to poor health outcomes and even death.
It is being increasingly recognized that TBAs may have a role to play in improving health outcomes in developing countries because of their access to communities and the relationships they share with women in local communities, especially if women are unable to access skilled care
. Some countries, training institutes and non-governmental agencies are initiating efforts to train TBAs in basic and emergency obstetric care, family planning, and other maternal health
topics, in order to enhance the links between modern health care services and the community, and to improve the chances for better health outcomes among mothers and babies. There are some findings that targeted interventions for training TBAs can lead to reduced perinatal mortality. However, there is little evidence of largescale effectiveness of such programmes, as they are rarely integrated within a general strategy for improving maternal and child care.
s. They see their role to include promoting change in societal attitudes towards birth, and favouring the "art" of midwifery founded on maternal or compassionate instincts, rather than over-medicalization of this natural event.
Pregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...
and childbirth
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...
care provider. Traditional birth attendants provide the majority of primary maternity care in many developing countries
Developing country
A developing country, also known as a less-developed country, is a nation with a low level of material well-being. Since no single definition of the term developing country is recognized internationally, the levels of development may vary widely within so-called developing countries...
, and may function within specific communities in developed countries
Developed country
A developed country is a country that has a high level of development according to some criteria. Which criteria, and which countries are classified as being developed, is a contentious issue...
.
Traditional midwives provide basic health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
care, support and advice during and after pregnancy and childbirth, based primarily on experience and knowledge acquired informally through the traditions and practices of the communities where they originated. They usually work in rural, remote and other medically underserved areas. TBAs do not receive formal education and training in health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
provision, and there are no specific professional requisites
Healthcare provider requisites
Healthcare provider requisites refer to the regulations used by countries to control the quality of individual healthcare workers practicing in their jurisdictions and to control the size of the health labour market...
such as certification or licensure. They often learn their trade through apprenticeship
Apprenticeship
Apprenticeship is a system of training a new generation of practitioners of a skill. Apprentices or protégés build their careers from apprenticeships...
or are self-taught; in many communities one of the criteria for being accepted as a TBA by clients is experience as a mother
Mother
A mother, mum, mom, momma, or mama is a woman who has raised a child, given birth to a child, and/or supplied the ovum that grew into a child. Because of the complexity and differences of a mother's social, cultural, and religious definitions and roles, it is challenging to specify a universally...
. Many traditional midwives are also herbalists
Herbalism
Herbalism is a traditional medicinal or folk medicine practice based on the use of plants and plant extracts. Herbalism is also known as botanical medicine, medical herbalism, herbal medicine, herbology, herblore, and phytotherapy...
, or other traditional healers. They may or may not be integrated in the formal health care system
Health care system
A health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations....
. They sometimes serve as a bridge between the community and the formal health system, and may accompany women to health facilities for delivery.
Training and focus of work
Traditional birth attendants are often older women, respected in their communities. They consider themselves as private health care practitionersHealth care provider
A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities....
who respond to requests for service. The focus of their work is to assist women during delivery and immediately post-partum. Frequently their assistance includes helping with household chores.
However, TBAa have no modern training on how to attend pregnant women, including how to recognize and respond appropriately to complications of pregnancy
Complications of pregnancy
Complications of pregnancy are the symptoms and problems that are associated with pregnancy. There are both routine problems and serious, even potentially fatal problems. The routine problems are normal complications, and pose no significant danger to either the woman or the fetus...
. For this reason, the way many attended the delivery was risky for women and their babies, leading to poor health outcomes and even death.
It is being increasingly recognized that TBAs may have a role to play in improving health outcomes in developing countries because of their access to communities and the relationships they share with women in local communities, especially if women are unable to access skilled care
Birth attendant
A birth attendant, also known as “skilled birth attendant” , is a midwife, physician, obstetrician, nurse, or other health care professional who provides basic and emergency health care services to women and their newborns during pregnancy, childbirth and the postpartum period...
. Some countries, training institutes and non-governmental agencies are initiating efforts to train TBAs in basic and emergency obstetric care, family planning, and other maternal health
Maternal health
Maternal health refers to the health of women during pregnancy, childbirth, and the postpartum period. It encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to reduce maternal morbidity and mortality.Preconception care can include...
topics, in order to enhance the links between modern health care services and the community, and to improve the chances for better health outcomes among mothers and babies. There are some findings that targeted interventions for training TBAs can lead to reduced perinatal mortality. However, there is little evidence of largescale effectiveness of such programmes, as they are rarely integrated within a general strategy for improving maternal and child care.
Lay midwifery in developed countries
In developed countries, some traditional or lay midwives are becoming increasingly vocal in support of their right to practice without formal regulation, advocating for a woman's right to choose her place of birth and birth attendantBirth attendant
A birth attendant, also known as “skilled birth attendant” , is a midwife, physician, obstetrician, nurse, or other health care professional who provides basic and emergency health care services to women and their newborns during pregnancy, childbirth and the postpartum period...
s. They see their role to include promoting change in societal attitudes towards birth, and favouring the "art" of midwifery founded on maternal or compassionate instincts, rather than over-medicalization of this natural event.