Glossary of Terms

Basic emergency obstetric and newborn care (EmONC): Basic emergency obstetric and newborn care, provided in health centres, large or small , includes the capabilities for:

• Administration of antibiotics, oxytocics, and anticonvulsants
• Manual removal of the placenta
• Removal of retained products following miscarriage or abortion
• Assisted vaginal delivery, preferably with vacuum extractor
• Newborn care

Comprehensive emergency obstetric and newborn care: Typically delivered in district hospitals, includes all basic functions above, plus Caesarean section, safe blood transfusion and care to sick and low birthweight newborns, including resuscitation.

Enabling environment: In the context of safe motherhood, describes a context that provides a skilled attendant with the backup support to perform routine deliveries and make sure that women with complications receive prompt emergency obstetric care. It essentially means a well-functioning health system, including equipment and supplies; infrastructure and transport; electrical, water and communication systems; human resources policies, supervision and management; and clinical protocols and guidelines.

Fistula: An injury in the birth canal that allows leakage from the bladder or rectum into the vagina, leaving a woman permanently incontinent, often leading to isolation and exclusion from the family and community.

Maternity workforce: Total workforce needed for maternity care: includes midwives and other with midwifery skills, but also obstetric and surgical staff, paediatric (neonatal physicians and nurses), laboratory technicians, radiologist etc.

Maternal morbidity: Refers to serious disease, disability or physical damage such as fistula and uterine prolapse, caused by pregnancy-related complications. Maternal morbidity is widespread, but not accurately reported.

Maternal mortality: According to the Tenth International Classification of Diseases, a maternal death is defined as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.”

Maternal mortality rate: This measurement, the number of deaths per 100,000 women in the 15-49 age group, measure the impact of maternal deaths on the population of women as a whole, not just on pregnant women. The statistic is affected by two factors: the risk of death among pregnant women and the proportion of women who become pregnant each year. The maternal mortality rate can be lowered either by making childbirth safer or by reducing the fertility rate in the population.

Maternal mortality ratio: The number of maternal deaths per 100,000 live births measures the risk of maternal death among pregnant or recently pregnant women. A more precise measurement would be the number of maternal deaths per 100,000 pregnancies, to account for those who die from unsafe abortions. However, data on number of pregnancies are difficult to obtain.

Midwifery: The scope of practice of professional midwives’ practice. The art and science of assisting a woman before during and after labour and birth

Midwifery workforce: Those healthcare workers whose ‘primary’ functions include health care to women in pregnancy, throughout labour and birth and health care of mothers and babies in the   postnatal period.

MOMS: Midwives and Others with Midwifery:  UNFPA has begun using the expression, MOMS (Midwives and Others with Midwifery Skills), rather than the term ‘birth attendant.’  This change reflects a recognition of the unique skills, roles and responsibilities midwives bring to delivery care, and to the central role that midwives play in making motherhood safer. The term ‘skilled birth attendant’ encompasses the definition of a midwife, but is more generic and broader. It also includes nurses, physicians and others with midwifery skills, as well as specialist obstetricians and gynaecologists.

Obstetric First Aid (OFA): Care that can be administered by qualified birth attendants at home or in facilities with minimal equipment. It includes uterine massage or bi-manual compression to reduce or stop bleeding, and the administration of antibiotics and antipyretics orally as a temporary measure if transport to more extensive facilities takes more than a few hours.

Primary health care (in the community): Level of health system close to where families live, such as a health post, clinic, government, private, NGO and the family home

Skilled birth attendant: A medically qualified provider with midwifery skills (midwife, nurse or doctor) who has been trained to proficiency in the skills necessary to manage normal deliveries and diagnose, manage, or refer obstetric complications. Ideally, skilled attendants live in, and are part of, the community they serve. They must be able to manage normal labour and delivery, perform essential interventions, start treatment and supervise the referral of mother and baby for interventions that are beyond their competence or not possible in a particular setting.

Skilled attendance (or skilled care): A skilled attendant operating within an enabling environment or health system capable of providing care for normal deliveries as well as appropriate emergency obstetric care for all women who develop complications during childbirth.

Traditional birth attendant (TBA): A community-based provider of care during pregnancy and childbirth. TBAs are not trained to proficiency in the skills necessary to manage or refer obstetric complications. TBAs are not usually salaried, accredited members of the health system. Although they are usually highly esteemed community members and are often the sole providers of delivery care for many women, they should not be included in the definition of a skilled attendant for the calculation of the Millennium Development Goal 5 target.

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