Some factors that have attributed to the decreased maternal deaths seen between this period are in part to the access that women have gained to family planning services and skilled birth attendance, meaning a midwife, doctor, or trained nurse), with back-up obstetric care for emergency situations that may occur during the process of labor. This can be examined further by looking at statistics in some areas of the world where inequities in women's access to health care services reflect an increased number of maternal deaths. The high maternal death rates also reflect access to health services between the poor communities compared to women who are rich.