Midwives' views of traditional birth attendants within formal healthcare in Nigeria.

Background: Discourses around the journey to motherhood in many poorly-resourced countries, particularly in the sub-Saharan African region, with no link to death and danger are limited. The custodians of traditional practices - the traditional birth attendants - are often blamed for the high maternal deaths in this region. Conventional institutional and international thinking about traditional birth attendants is that they are dangerous and therefore should no longer be allowed to practice. Aim: To explore midwives' views of traditional birth attendants' place within formal healthcare settings in Nigeria. Methods: Hermeneutic phenomenological and poststructural feminist approaches were used. Seven midwives volunteered for semi-structured individual face to face interviews. Findings: The responses of the midwives were diverse and conflicting. Some midwives believe that the traditional birth attendants should be banned, arguing that they are responsible for low uptake of hospital-based maternity care by women which in turn leads to an increase in maternal deaths. Contrastingly, other midwives expressed a view that the traditional birth attendants 'cannot be phased out' due to their valid contributions, particularly in the rural areas where access to formal maternity care is limited by intractable structural problems. Conclusion: Policy makers need to reconsider the role of traditional birth attendants. This should involve not only their integration into formal healthcare to work alongside formally trained maternity care providers, but also fostering a healthcare atmosphere where respect and recognition of each practitioner's skill is paramount. (C) 2019 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.