The mother arrived at LAMB Hospital in the early hours of the morning with no discernible blood pressure. She had delivered atnome several hours before, and continued to bleed until losing consciousness. The village health volunteer, recognizing the seriousness of the situation, organized blood donors and a van gari and accompanied the woman to the hospital. As soon as she arrived at the gate the guards rushed her to the maternity ward where advanced trained midwives sprang into action: starting an IV, treating shock? ordering blood; getting her history from the family and volunteer. By the time the on-call doctor arrived 15 minutes later, she was registering a blood pressure and imminent death had been averted. Midwives are central to providing skilled care to thousands of mothers and newborns each year through the LAMB health care system in Northern Bangladesh. They are a vital part of the team effort to provide quality emergency obstetric care in a timely manner around the clock- a team which starts in the community with village health volunteers, and community midwives, but also includes the guards at the hospital gate, lab personnel and medical doctors. Diploma Midwives are given a six month theoretical and practical course at LAMB where they learn to give quality care during pregnancy, normal labour and delivery as well as respond to and manage obstetric emergencies. After passing the exams and completing the required skill competencies they are recognized as Advanced Midwives. They follow set protocols, developed in consultation with the obstetric team and consult with the doctors when necessary, while retaining their status as professionals in their own right Advanced midwives are also part of the trainer’s team, providing clinical supervision for skilled birth attendant and midwife students at LAMB. Community Midwives, graduates of the government recognized six month skilled birth attendant course, work at Community Managed Safe Delivery Units at the Union level, in the LAMB system. These local women provide 24 hour care to women from their own community, working rotating shifts so that the unit is always open. In 2009 Community Midwives delivered over 2000 babies in 15 Safe Delivery Units and conducted over 35,000 antenatal care visits. Using partographs (an ‘at a glance’ visual graph of labour progress) to monitor the well being of the mother and unborn baby, and protocols to manage any departure from normal, community midwives are key to making timely and appropriate referrals for women needing hospital care. Both in community Safe Delivery Units and at LAMB Hospital, midwives are key players in the effort to ensure that women get the best care possible during pregnancy and delivery-and newborns get a good start to life.