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Maternal health remains a critical public health concern in Nigeria, particularly in rural areas where access to formal healthcare services is severely constrained. In many rural communities, Traditional Birth Attendants (TBAs) serve as primary providers of maternal care, yet their role remains poorly understood within the broader health system. This study examines the role of Traditional Birth Attendants and their impact on the health outcomes of reproductive-age women in rural communities of Yobe State from a sociological perspective. The study adopted a cross-sectional survey design involving 300 reproductive-age women selected through multistage sampling from rural communities in Yobe State. Data were collected using structured questionnaires and analyzed using descriptive statistics, chi-square tests, and binary logistic regression predicting TBA utilization. The findings reveal that 60.7% of respondents rely on TBAs for childbirth services, driven primarily by affordability (32.0%), cultural beliefs (29.3%), accessibility (24.7%), and trust (14.0%). Notably, 68.7% of respondents lacked formal education, and 71.3% reported household incomes below ₦30,000 monthly. Regression analysis demonstrated that education (OR=4.14, p<0.001), income (OR=3.97, p=0.001), and distance to health facilities (OR=2.56, p=0.003) significantly predicted TBA utilization. TBA-assisted deliveries were associated with higher complication rates (49.5% vs 35.6%), with TBA use independently predicting complications (OR=2.36, p=0.006). The study reveals a complex paradox: while TBAs provide culturally appropriate and accessible care, their limited training in complication management contributes to elevated maternal morbidity. However, emerging evidence from Nigerian studies demonstrates that trained TBAs integrated into formal referral systems can significantly improve maternal outcomes. The study concludes that TBAs remain an indispensable component of rural maternal healthcare in Yobe State, but their potential can only be realized through systematic training, integration, and supportive supervision. The study recommends a dual-track approach: immediate investment in TBA training and referral strengthening, alongside long-term expansion of rural primary healthcare infrastructure. Keywords: Traditional Birth Attendants, Maternal Health, Rural Communities, Reproductive-Age Women, Yobe State, Health Systems Integration, Social Determinants of Health