According to a joint study done by WHO and other organisation, in the year of 2008, 358, 000 maternal deaths occurred globally from preventable complications that occurred during pregnancy and child birth. Of these deaths, the majority (99 percent) of the maternal death occurred in developing countries, and 87 percent of the total death occurred in South Asia and Sub-Sahara Africa (countries in Africa under Sahara desert in which Ethiopia is also situated). Global perinatal mortality is also estimated to be about 7 million deaths every year (3.5 million stillbirths and 3.5 million deaths in the first seven days). This death toll is more than the combined annual deaths globally due to HIV/AIDS (2.1 million), tuberculosis (1.6 million) and malaria (1.3 million), which together add up to 5 million lives lost.

All these data show you that globally the maternal and neonatal mortality and morbidity is very high, and the majority of it occurs during and around labour and delivery. It also shows you that most of it happen in less developed countries like Ethiopia where most deliveries occur without the assistance of skilled health professionals who could have managed deliveries well and avoid the needless death of mothers and their babies.

According to the global target set for 2015, 90 % of births should be attended by skilled birth attendant. WHO in 2011 also reported that the proportion of deliveries attended by skilled health providers rose from 58 percent in 1990 to 68 percent in 2008 worldwide, but remained at only about 50 percent in Africa. This shows that most counties are way behind the global target. Even more, countries in Africa need to have an intervention that will increase the number of births that are attended by a skilled health professional.

In Ethiopia, the labour and delivery service are still at its lowest in the world where more than 94% of pregnant women labour and deliver at home unattended by a skilled health professional. Probably that is why more than 10,000 Ethiopian women are suffering at home from one of the morbid complications of obstructed labour (fistula, an opening between the birth canal and other internal organs), and the maternity wing of almost all public hospitals outside Addis Ababa are filled by women with complications due to obstructed labour.

Therefore, all of these findings clearly indicate that the lives of many mothers and their babies could be saved if their births were attended by well-trained health professionals who could manage the emergency of labour and deliveries well. Because of this fact currently, it is recommended that every labouring mother should be attended by a skilled person either at a health facility or home. The aim is to conduct a clean and safe delivery for the majority, and early detection and referral for those women and babies who develop complications.

This Labour and Delivery care Module are prepared in such a way that you will be equipped with the basic principles and practice of managing standard delivery at health post and home level. It has seven study sessions. You will first learn how you could promote institutional delivery; then you will learn in detail the character of normal labour, differentiate true from false labour and describe the stages and mechanism of labour. You will also learn how to assess labour, identify the major components of partograph and indicators for good progress of labour.

Much of the module is dedicated to the preparations and skills for supporting the mother through the stages of labour and conducting normal delivery. The module also introduces you to the basic techniques of newborn resuscitation, early identification and referral of mal-presentation, mal-positions and twin pregnancy. All of the principles and techniques taught in this Module will be reinforced and expanded in your practical skills training. Blending the theory and practice of labour and delivery care will enable you to support the health and the survival of labouring women and newborns in your community.

Most of the content of this module is extracted from level IV Health Extension practitioners training program module and tailored for the level three training program.


Last modified: Tuesday, 21 March 2017, 4:00 PM