Key points
- Care by skilled health professionals before, during and after childbirth can save the lives of women and newborns (WHO).
- A skilled birth attendant is a midwife, doctor or nurse — traditional birth attendants are not counted as skilled attendants (WHO).
- About 99% of births in high- and upper-middle-income countries are attended by a trained midwife, doctor or nurse, against 73% in low-income countries (WHO).
- Since 2018, WHO's joint definition of a skilled birth attendant has focused on competency, not only on being present.
Direct answer: Safe childbirth means a birth attended by a skilled health professional. Care by skilled health professionals before, during and after childbirth can save the lives of women and newborns (WHO). A skilled birth attendant is a midwife, doctor or nurse. About 99% of births in high- and upper-middle-income countries are attended by a trained midwife, doctor or nurse, against 73% in low-income countries and 84% in lower-middle-income countries. This page is awareness only: it explains what skilled care is and how common it is, and it gives no advice for any individual birth.
What a skilled birth attendant is
A skilled birth attendant is a midwife, a doctor or a nurse — a health professional trained to care for a woman and her baby during pregnancy, childbirth and the postnatal period. Traditional birth attendants are not counted as skilled attendants by WHO: they may be experienced and trusted in their communities, but they are not trained health professionals, and they are not an acceptable substitute for skilled attendance at birth. The distinction is a definition, not a judgement of any individual: it is how WHO counts coverage, and it is why the coverage figures below mean what they mean.
How many births have skilled attendance
The figures are WHO’s, from the maternal mortality fact sheet published 7 April 2025. About 99% of births in high- and upper-middle-income countries are attended by a trained midwife, doctor or nurse, against 73% in low-income countries and 84% in lower-middle-income countries. The gap is the story: more than a quarter of births in low-income countries happen without a skilled attendant, and those are the countries where maternal deaths are concentrated — the MMR is 346 per 100,000 live births in low-income countries, against 10 in high-income countries. Skilled attendance is not a luxury added to a birth; it is the difference between a birth where complications can be recognised and managed, and one where they cannot.
Competency, not only presence
Since 2018, WHO’s joint definition of a skilled birth attendant has focused on competency, not only on being present. A person counts as a skilled attendant because of what they can do — the skills to manage a normal birth, recognise complications, and refer when needed — not only because they were in the room. General guides still quote headcount only: how many births had “a skilled attendant present”. The competency point matters because a headcount can overstate safety: a birth can be attended, and still not be safe, if the attendant lacks the skills, the equipment, or the referral route. This page states the shift and goes no further into the 2018 definition’s detail, which is written for health systems, not for a general audience.
Why skilled care saves lives
About 75% of maternal deaths are from major complications: severe bleeding (mostly after childbirth), infections (usually after childbirth), high blood pressure in pregnancy, complications from delivery, and unsafe abortion — most preventable or treatable (WHO). Skilled care is the mechanism that connects the complication to the treatment: the attendant who recognises heavy bleeding, who can manage it or refer, and who stays through the hours after birth when most deaths happen. The same attendance protects the newborn: 2.3 million newborns died in their first 28 days in 2024, and preventing those deaths requires skilled health personnel at birth alongside essential newborn care (WHO, 1 May 2026). The companion guides on newborn care and postnatal care cover the baby’s side of the same birth.
What this page does not do
This page does not describe what happens during labour, does not list what a woman should expect at birth, and does not advise anyone on where or how to give birth. The intrapartum guidance — WHO’s 2018 recommendations on intrapartum care for a positive childbirth experience, with 56 recommendations — is written for health workers, and this page links to WHO rather than summarising it. A birth plan is a personal decision made with a clinician; a global awareness page is not the place for it.
Frequently asked questions
What is a skilled birth attendant?
A midwife, doctor or nurse trained to care for a woman and her baby during pregnancy, childbirth and the postnatal period (WHO).
How many births have skilled attendance?
About 99% in high- and upper-middle-income countries, 84% in lower-middle-income countries, and 73% in low-income countries (WHO).
Are traditional birth attendants skilled attendants?
No. Traditional birth attendants are not counted as skilled attendants by WHO — skilled attendance means a midwife, doctor or nurse.