Recently the British Medical Journal reignited an old debate about the role of traditional birth attendants in terms of whether or not they actually help more than they hurt by essentially giving women false hope and preventing them from seeking out other care. This debate has played out elsewhere including the Maternal Health Taskforce Blog.

I am actually not sure how I feel about the issue, mostly because I have not seen very good studies of the issue, and believe that there is actually a lot of heterogeneity in the term traditional birth attendant so it is hard to generalize. But it is true that there is a lot of misunderstandings and lack of consensus on this topic.

An article in today’s Graphic here in Ghana reminded me of this confusion:

News clipping from Graphic, June 23, 2011

Talk about giving a confusing message.

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6 Responses to “Do traditional birth attendants do more harm than good?”

  1. Karen,

    Thanks for the link back to our blog. I think you raise some of the same concerns that I have about whether or not TBAs are “good,” particularly regarding who is considered a TBA. I think we want to discourage the use of TBAs with actively harmful practices or unhygienic practices, but having a person present who has attended births before and has some experience is probably better than nothing.

    Somehow, we need to delineate between types of TBAs to give proper definitions and to promote safer practices. Something like: 1) TBAs with actively harmful practices (TBAWAHPs?), 2) TBAs without actively harmful practices, and 3) TBAs with some level of training in modern methods. Sure, the acronyms need some work, but we often end up talking past each other since we all have a different concept of what a TBA is.

  2. Do Traditional Birth Attendants do More Harm than Good? @KPMcDonald

  3. Do Traditional Birth Attendants do More Harm than Good? @KPMcDonald

  4. RT @KarenGrepin: Do traditional birth attendants do more harm than good?

  5. Andrew Glover says:

    tradition birth attendance are doing more good than harm because in a community where our health system come not reach those places if we have the tradition birth attendance[TBAs] can attend to our women who will be in @ the time there is no mid-wife they can help save the child from having any defect so we need them in our them in the hard place reach help our women the community.THANK YOU.

  6. Hebert Ringanayi says:

    I would rather contribute by questioning what might be sensitive to point out in our tradition. It is generally good to keep and maintain our culture and traditions but unfortunately there are some traditional practices which we are not proud of but not bold enough to call a spade a spade. The role of TBAs is acknowledged for giving a service to women, with no access to health services, who were going to have uncomplicated deliveries which are not our main worry anywhere. The train assess cadres in or working with the health care system monitor, identify, anticipate and prepare to and actually deal with most of the risks and complications of pregnancy and delivery. When it comes to the risky and complicated pregnancy and delivery the TBAs does not offer much to say the list. Documentation of neonatal and or maternal morbidity, let alone mortality, is non existent. A way to complement the two parallel services should be found. What i dislike the hypocrisy and double standards. The same system which does not allow a nurse with no midwifery to conduct a delivery a in a hospital set up where help is within an earshot would on the other hand would passionately support a TBA 100km beyond rivers and mountains. The pregnant lady’s labour has minimal monitoring or simply watching rather in addition to not having enough resources to deal with the potential complications like transport, skill, equipment meaningful help etc. Neither the nurse/doctor nor TBA alone can solve the maternal and child health problems. It seems a well coordinated complementary system might be relatively. If the golden minute of the help the baby breathe is so crucial how is it applicable to the TBAs with no suction and oxygen just to mention a few things

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