Since 1998, the Maternal Mortality Update, a biannual publication of UNFPA, has documented strategies, partnerships and projects for reducing maternal mortality and morbidity in the developing world. This year's update focuses on the importance of skilled attendance at birth for improving maternal health, which is one of the eight Millennium Development Goals. It was published in collaboration with the Skilled Attendance For Everyone (SAFE) research study and the Initiative for Maternal Mortality Programme Assessment (IMMPACT), Dugald Baird Centre for Research on Women?s Health, University of Aberdeen. This report summarizes recent trends in maternal mortality, examines the importance of medically trained attendants who have emergency backup, and offers approaches for improving the level of care women receive during childbirth.