298 treatments as one of the main reasons for maternal death. The service providers faced more difficulties convinci ng women from ethnic minority groups to seek treatmen L This hesitatio n stems from cultural barriers and language unfamiliarity (21) Births attended by health professionals iucceased from 56 percen l in t998 to 60 percent in 2003. The goal is to hnve So% of all births attended by skilled health attendants. Based on current data, 61% of births occurred in t Jie homes while 38% in health facilities. Hornedeliv eryisanotherimportant. nursing intervention. Republic Act No. 9173 states that nursing care of individual s, families and communiti _es in any health care setting and includes but not limited to nursing care during concept. ion, labor, ddivery. It also the duty of the nurse to perfom1 internal examination during labor in the absence of antenatal bleeding and delivery. Birth attendance by professiona l health ¼lorkers will be a significant step in having better risk assessment and referral. If the person handling the delivery is well trained, t]1ere is a greater chance of detecting pelvic inadequacy and fetal malposition. The client vrul benefit from a more skilled practitioner doing abdominal and internal examination. The DOH came out with a Protocol for Horne Deliveries tb. rough DOH Department Circular No. 187-As. (Compiled Policies 1994, p. 46) (4) This circular allows licensed nurse-midwives and nurses trained in delive. ry to conduct home deliveries. License d physician s, midwives and trained traclitional birth attendants or hilots (allowed only in areas where there are no licensed physicians, nurses, midwives or no available health professional at the time of delivery) are also listed as other legitimate birth attendants. For nurses adequately trained in labor and delivery, this is an important opportunity for nursing practice. Since most births in the rural areas happen in the homes, the Protocol for Home Deliveries v. ill help in ensuring safety of the woman and baby. The list below shows the DOH criteria on who are qualified to have home deliveries... Adctitiona J assessment pointers for the nurse are al. so included: Pointers Quallflcatfons For Home Delfverv Take a complete history and examlnadon on Full term (9 months) current pregnl!ncy. Compar:e the l!!Stfmated age of aestatron by the last menstrual by the last 2nd to 4th delivery menstrual period (LMP) and the measurement of the tundlc height. Complete lnformatfon on Gravrda, Parity and TPAL score.. 