What are Traditional Birth Attendants?
Traditional Birth Attendants (TBAs) are common in many parts of the world. Attendants usually learn their skills from older attendants in the village, and for many families in remote areas and indigenous communities, they are the first port of call when giving birth.
They are often called on when a woman starts to deliver or if she starts to have problems. Attendants often act as a source of general information for women, and may give advice before or after birth about cultural traditions. If trained, they might also provide nutritional advice.
New report on Sierra Leone
The Free Healthcare Initiative in Sierra Leone has inadvertently had a negative effect on Traditional Birth Attendants bringing women to clinics to give birth. Read more about this and our recommendations to create new Maternal Health Promoters across the country.
Report on free healthcare initiative in Sierra Leone (540.62 kB)
Why do indigenous women use Traditional Birth Attendants?
Indigenous women may not only live some distance from a health centre, but if they make the trip they may find themselves discriminated against by health professionals who do not speak their language or may hold strong prejudices about them.
Sometimes women find that practices in hospitals go completely against their cultural norms. They and their families often have more confidence in traditional birthing practices than in modern medical techniques.
What are the drawbacks of Traditional Birth Attendants?
Communities that rely on TBAs may find that attendants and local health centres do not cooperate with each other. Attendants may not carry out routine antenatal checks, which can be a particular problem if an emergency arises.
While attendants generally perform a valuable role, if they are not trained there can be some dangerous practices. For example in Nicaragua one practice is for attendants to massage the stomach to try and induce the birth. However, this can lead to the umbilical cord strangling the baby. In Sierra Leone another practice is to sit on the mother’s stomach to induce the birth, but this can lead to injury to the woman’s birth canal (called fistula).
What role should Traditional Birth Attendants play?
Ideally every woman should have access to skilled help at birth – meaning that trained medical staff are present, with the equipment to cope with emergencies such as providing caesarean section or blood transfusion.
The reality is that in many parts of the world health systems simply don’t have the staff or resources to provide appropriate services. Until they do, the role of attendants will continue to be crucial in providing antenatal care, referring mothers to health centres when necessary, and reducing deaths related to childbirth.
“The way doctors treat us here and in any place, even in Managua, we are discriminated against because we are Miskitu…we sometimes say that pregnant women have a foot here and the other in the cemetery because anything can happen during labour.”
Patricia Zacarias – IMATWA, a local organisation working with Health Poverty Action in Nicaragua.
What is Health Poverty Action doing to help?
- In Peru, Health Poverty Action has worked with Traditional Birth Attendants to improve their skills and to discourage harmful practices.
- With displaced and indigenous people in the northern Kachin region of Burma Health Poverty Action has trained Traditional Birth Attendants to refer pregnant women to health facilities.
- Amongst hill tribes in Attapeu Province, Laos Health Poverty Action has provided training for Traditional Birth Attendants on safe delivery methods
Read our report from Cambodia
Report on maternal health in Cambodia (3.46 MB)
Last modified: 07/01/2011
