WHO, ICM and FIGO launch: 'making pregnancy safer: the critical role of the skilled attendant'; ICM Secretary General Kathy Herschderfer introduces a ground-breaking joint statement that underscores the importance of midwifery skills in safe motherhood.

• Auteur: Herschderfer, Kathy

Making pregnancy, safer:, the critical role of the skilled attendant is a statement produced jointly by the World Health Organization (WHO), the International Confederation of Midwives (ICM) and the International Federation of Gynaecologists and Obstetricians (FIGO). Its focus is the importance of a person with midwifery skills being present during a woman's labour and delivery. The statement represents official recognition at global level that this presence is the highest priority in the endeavour to achieve safe motherhood and the 5th Millennium Development Goal--a 75% reduction in maternal mortality ratios before the year 2015. I attended the launch of this powerful new document, which took place in Geneva, Switzerland, in November 2004.

Midwives and 'skilled attendants'

The crucial need for skilled attendance during a woman's labour and delivery is widely acknowledged. However, fill now, there has been a lack of precise definition of who a skilled attendant is and what exactly she or he can and will do. This new joint publication successfully clarifies the issues and provides evidence-based guidance so that work to build the level of human resources needed can continue on an assured basis.

The introduction to the statement makes clear that:

'Skilled care refers to the care provided to a woman and her newborn during pregnancy, childbirth and immediately after birth by an accredited and competent health care provider who has at her/his disposal the necessary equipment and the support of a functioning health system, including transport and referral facilities for emergency obstetric care. Since skilled care as defined above can be provided by a range of health professionals, whose titles may vary according to specific country, contexts, it has been agreed to refer to this health care provider as the "skilled attendant" or, "skilled birth attendant", so as to avoid confusion over titles. Thus:

A skilled attendant is an accredited health professional--such as a midwife, doctor or nurse--who has been educated and trained to proficiency in the skills needed to manage normal (uncomplicated) pregnancies, childbirth and the immediate postnatal period, and in the identification, management and referral of complications in women and newborns.

... In issuing this statement, WHO, ICM and FIGO are advocating for skilled care during pregnancy, childbirth and the immediate postnatal period. This statement is especially, aimed at countries in which the...