Reproductive Health in Developing Countries...SUMMARY: "Multiple confounders with important interaction make a cause & effect analysis difficult when discussing factors contributing to decrease reproductive mortality. Every sector taken up to be improved is a step towards the objective of improving women?s well-being. Findings of this literature review are: traditional midwives (TMs) as contraceptive distributors are not significant in reducing reproductive deaths. The main killer among mothers in Burma and along the Thai-Burma border is unsafe, septic, induced abortion. Even if TMs cannot provide emergency obstetric care, as distributors of modern contraception they could affect the maternal mortality in four ways. 1: Reducing number of pregnancies, which decreases the number of times women face risk of maternal death. 2: High-risk pregnancies at higher parities can be avoided. 3: Women can avoid unwanted pregnancy, which may end in unsafe abortion or in not seeking care or in abandoning a baby. 4: Involving TMs in contraceptive services may replace their practice of inducing unsafe abortions. As long as most of the deliveries are still at home with indigenous midwives maternal mortality can not be reduced below 100/100,000, even if there is functioning emergency obstetric care (EmOC) available. Examples from Brazil and China have shown this It is still realistic that the present high mortality from over 600/100,000 in Burma?s internally displaced people (IDP) areas can be significantly reduced. Fertility regulation is not a substitute for obstetric care in a limited budget country, but they should work together. TMs have been utilized in some countries by integrating them successfully into existing health systems. Even in countries with political stability the reduction of maternal mortality took decades. In an unstable population disrupted by civil war additional factors delay the process. To overcome the feminization of poverty girls schooling is to be promoted. The number of girls in secondary schools needs to be increased, so that the coming generation has a better understanding of health issues. No RH prospective intervention studies about postemergency settings with TM programmes for fertility regulation have been found in the literature. There cannot be one monopolized concept for healthcare or for safe motherhood, or for population stabilization. We need measured tailored projects for every ethnic group in its circumstances reaching each needy individual. If one way does not bring the expected results, the strategy must be changed. With motivated skilled midwives from the Backpack Health Worker Team (BPHWT) and additional trained EmOC-staff, who can form a link in a transition period until there are enough literate skilled midwives, as many lay midwives as possible should be offered training on a voluntary basis with as many skills as they can take in. Disarmament of rebel groups and peace negotiations are essential."