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Obstetrical referrals by traditional birth attendants
Journal of Ayub Medical College, Abbottabad : JAMC
|March 28, 2014
Summary
Traditional Birth Attendants (TBAs) in Pakistan often miss or delay referrals for life-threatening obstetric conditions, leading to high near-miss morbidity and mortality ratios. Improving TBA training is crucial for better maternal outcomes.
Area of Science:
- Obstetrics and Gynecology
- Maternal Health
- Public Health
Background:
- Traditional Birth Attendants (TBAs) conduct 90% of births in Pakistan.
- TBAs frequently misdiagnose complications and delay critical referrals.
- This study investigates outcomes of life-threatening obstetric conditions referred by TBAs.
Purpose of the Study:
- To determine the prevalence of life-threatening obstetric conditions (LTOCs) in patients referred by TBAs.
- To analyze the nature and outcomes of these LTOCs.
- To assess the impact of TBA referrals on maternal near-miss morbidity and mortality.
Main Methods:
- An observational, descriptive study was conducted from January to December 2007.
- Data was collected from patients referred by TBAs to Fatima Hospital, Baqai Medical University.
- The study focused on patients presenting with LTOCs.
Main Results:
- 7.8% of patients were referred by TBAs, with 82.8% having LTOCs.
- Near-miss morbidities and mortalities were observed in 84.9% and 15% of cases, respectively.
- Obstructed labor and postpartum hemorrhage were major causes of near-miss events and mortality.
Conclusions:
- The ratio of maternal mortality to near-miss morbidity is high.
- Misidentification and delayed referrals by TBAs contribute significantly to adverse maternal outcomes.
- Enhanced training and support for TBAs are essential to reduce preventable maternal morbidity and mortality.
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