Delivery life support: a preliminary report on the chain of survival for complicated deliveries in rural Cambodia.

Most programs to reduce maternity deaths focus on hospital performance and general obstetric protocols. In communities where most mothers deliver at home, such strategies will not reduce avoidable deaths. The key concept in the actual intervention is to regard deliveries in poor rural communities as a trauma and to merge midwives and traditional birth attendants (TBAs) with an already existing and successful rural trauma rescue system. A total of 256 Cambodian careproviders, 41 health center midwives and paramedics, plus surgical teams at local hospitals were trained over a 2 year period. After completing the training program, the participants themselves rated their skills, confidence, and quality of team work by Visual Analog Scale measurement. The results demonstrate significant improvement, both for the TBAs and the certified midwives. The intervention results so far indicate that delivery life support training to rural careproviders increases their capacity to cope with emergency obstetric cases.