Just having a trained healthcare professional during labor and delivery is one of the simplest, most definitive ways to protect mothers and babies. Yet across the world, millions of births go without a skilled attendant each year. It’s that presence, during those moments when contractions commence and the first hours thereafter, which makes a world of difference between life and death.
The Importance of Skilled Attendance
A skilled birth attendant, according to the WHO (World Health Organization), is a trained midwife, nurse, or physician who can oversee a typical delivery and ascertain the need for higher-level care when issues arise. The attendance of a trained professional is important, from sterile practices to immediate responses to chorioamnionitis, postpartum hemorrhage, failure to progress, and neonatal respiratory distress.
Statistics have shown that countries that provide improved access to skilled attendance at birth have maternal and neonatal mortality rates that reflect a reverse phenomenon. Maternal mortality is reduced by nearly 20% and the neonatal mortality rate of babies dropped by 25%. These are not just numbers but lives saved with timely action.
Barriers that Keep Skilled Attendance Low
However, despite all of this information, the global shortage of trained midwives and obstetric care providers is one of the largest unmet needs in maternal-fetal health. This occurs primarily within areas of rural communities. Sub-Saharan Africa and South Asia have shown that only one in two women has access to trained care during childbirth.
This relates to a variety of factors. Health systems lacking adequate staff emerge from funding for trained practitioners not being supported, staffing discrepancies favoring urban settings over rural, and healthcare professionals migrating to better-heeled areas with more room and resources. Furthermore, cultural elements affect this situation as many families favor home births due to hospital mistrust, culturally motivated homebirth, and payment ended for transportation/time lost at work, preventing accessible resources.
Programs Developing to Close this Gap
Many programs seek to close this gap. Midwifery schools in Ethiopia and Nepal in the U.S. have adopted an increase in intake over the past few years, with newly opened village-level birthing centers providing access through community health workers. Task-shifting models, where nurses and midwives are given additional certifications to render emergency procedures reserved for those with doctorates, provide more access to quality care.
However, one of the best solutions is maternity waiting homes, which provide accommodations for those not living in proximity to hospitals so they can stay while waiting for imminent labor. Coupled with referral of service systems and community outreach plans, these ensure women are less likely to go without any care.
A Way Forward
Universal access to skilled birth attendance is achievable, provided funding, training, and political will to support maternal and infant health remain.
There’s someone there when life begins in an ideal situation. Closing this gap is one of the easiest ways to support a safe delivery for all.
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