title: Traditional birth attendants issue: a menace in developing countries.
abstract: BACKGROUND
  A significant proportion of births in Nigeria still occur at homes of traditional birth attendant. Traditional birth attendants are popular in developing and low resource countries. They lack no formal education or medical training and their clients end up with obstetric complications which lead to severe morbidity and mortality.
  
  
  METHODS
  Two cases of pregnant women that engaged the services of traditional birth attendants (TBA) before presenting at a health facility are presented. They ended up with severe morbidity and mortalities. A 29 year old gravida 3 + para 2+0 woman with two previous caesarean section(C/S) was counselled for elective c/s but declined. She presented at the home of a TBA, had spontaneous vagina deliver, collapsed one hour after delivery and was dead by the time she was brought to the hospital. A 30 year old gravida 10 para 7 + 3 presented in hospital after being in labour at the home of a TBA for three days. On presentation in hospital there was absent foetal heart sound. At surgery there was ruptured uterus and subtotal hysterectomy was done.
  
  
  CONCLUSIONS
  To improve the situation better access to optimal antenatal care and intrapartum care together with early referral of high-risk patients must be facilitated. Increased community awareness, promotion of appropriate technology for effective health care planning strategy from the grassroots level to tertiary centres is important in the reduction of obstructed labour. One of the most effective means of reducing maternal mortality is the provision of caesarean section for all women who need it.
authors.affiliation: Formerly General Hospital, Aliero, Nigeria. yvonnebuowari@yahoo.com
authors.forename: O Y
authors.initials: OY
authors.lastname: Buowari
mesh_terms: D000328:Adult; D003469:Culture; D003906:Developing Countries; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008880:Midwifery / Q000193:education; D009549:Nigeria; D036801:Parturition; D011247:Pregnancy; D011787:Quality of Health Care