Home Deliveries in Rural Assiut Governorate: The Role of The Trained Nurse Midwife

Background: Skilled attendance at delivery is a key intervention to reduce maternal and
neonatal deaths. Rural women may be less likely to be attended by skilled providers. In
Egypt, Ministry of health and Population (MOHP) had undertaken tremendous efforts in
training nurses on midwifery skills. Objective: The study aimed to estimate proportion of
home deliveries attended by the trained nurse midwives, to identify factors associated with
choosing home birth attendants and to describe midwifery practice and satisfaction of the
midwives. Methods: A cross sectional survey was conducted in 30 randomly selected
villages of Assiut Governorate. Mothers who gave birth at home in year 2012 and all
midwives who work in the selected villages were interviewed. Results A total of 319
women and 33 midwives were included in the study. Daya was the birth attendant in
40.4% of deliveries while midwives attended 14.4%. The percentage of using skilled birth
attendants was significantly higher in women who were aware about midwives and who
were previously delivered by skilled persons (p < 0.001). About 21 % of midwives
reported they have fear to deliver a woman, 54.5% prefer doctor presence with them.
Conclusion Less than one fifth of women were attended by the midwives. Information
about midwives and not having a previous delivery by a daya were the factors that
determine choosing of the nurse midwife as a birth attendant. Developing an awareness
campaign to increase women knowledge about the availability and competence of
midwives might encourage using them as birth attendants.