An audit of postpartum referrals by traditional birth attendants in rural Southeast Nigeria

Context: Immediate recognition of postpartum complications, prompt, and due management are key to reduction in maternal mortality ratio (MMR). Aims and Objectives: To evaluate the pattern and outcomes of postpartum referrals from traditional birth attendants (TBAs) in rural Nigeria. Materials and Methods: A prospective observational study of patients referred after delivery from TBAs to a Mission Hospital in rural Nigeria. Analysis was by Epi Info statistical software. Results: Two hundred and sixty-two patients were so referred. Perineal injury (29.4%) was the most common diagnosis followed by pyrexia (22.5%), postpartum hemorrhage (18.3%), and genital sepsis (10.3%). The MMR was 4961.8/100,000 live births with PPH accounting for the majority (53.8%). Conclusion: Delay in referral and transportation difficulties were major impediments to prompt access of care from the Mission Hospital. TBAs should be encouraged to refer all cases to well-equipped orthodox medical facilities and get paid for each case as if managed by them.