Rate of home delivery and participation of traditional birth attendants is declining in selected areas of Dhaka city

Unassisted delivery or assisted by untrained or unskilled birth attendance is a public health issue associated with maternal mortality and morbidity around the world. A 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. Birth attendants are trained to be present at childbirth, whether the delivery takes place in a health care institution or at home, to recognize and respond appropriately to medical complications, and to implement interventions to help prevent them in the first place including through prenatal care.1 Traditional birth attendants (TBAs) play an important role in regions where most births take place in the home2 and, in Asia, constitute the largest single group of birth attendants (41% of births).3 According to The World Health Organization (WHO), TBA is “a person who assists the mother during childbirth and initially acquired her skills by delivering babies herself or through apprenticeship to other TBAs”.4 TBAs are integral members of their communities and provide an important window to local customs, traditions, and perceptions regarding childbirth and newborn care.5,6 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.7 TBAs provide the majority of primary maternity care in many developing countries and may function within specific communities in developed countries.