Background: Many pregnant females in rural Africa recommend traditional birth attendants (TBAs) services over trained midwives as they believe childbearing is normal rite of passage for females and is assumed to be free of problems that TBAs can easily control. Aim and objectives was to shed light on obstetric traditions and cultural behaviors and was to identify the factors related to the choice of birth attendants in home delivery and to assessment of safety of midwifery practice and satisfaction of women underwent home deliveries. Subjects and methods: The current study was a mixed study, retrospective study on 50 women who delivered at home and prospective on 100 women delivered at Obstetrics and Gynecology Department of Al-Azhar University Hospital Assiut. Results: There was non-significant variations among groups (P>0.05) regarding maternal mortality, 3^rd or 4^th degree tear, history of postpartum hemorrhage. However, there was significant difference concerning history of maternal infection, Conclusion: Rates of maternal and fetal adverse results for this study in Assiut with well-established and integrated community midwifery were high overall except postpartum hemorrhage, maternal mortality and caesarean section (CS) rate. Well-trained midwives may have a role in reducing CS rate. Midwife delivery is not as bad according to our study as it is showing low rate of postpartum hemorrhage and caesarean section.