A joint study led by researchers from the World Health Organization (WHO) and the University of Birmingham has found a potential solution to reducing deaths due to postpartum hemorrhage. The new solution is called E-MOTIVE.
Approximately 14 million women experience this phenomenon each year, leading to around 70,000 fatalities – or one death every 6 minutes – mostly in low-income countries.
The study, which enrolled over 200,000 participants from four countries, focused on utilizing a simple and cost-effective drape collection device combined with recommended treatments as part of an integrative approach rather than working through them sequentially.
Overwhelmingly positive results have been reported thus far; severe bleeding rates were reduced by 60%, and mortality rates decreased significantly as well.
In addition, there’s been a substantial decrease in blood transfusion rates for bleeding patients due to limited blood supply often found in underprivileged regions.
These endeavors show great promise for improving the field of global maternal health care. According to Professor Arri Coomarasamy who headed the trial and is Co-Director of the WHO Collaborating Centre on Global Women’s Health at the University of Birmingham: “Time is key when responding to postpartum bleeding; any interventions that eliminate delays in diagnosis or treatment will undoubtedly be game-changers for maternal health.”
Dr. Pascale Allotey, Director of Sexual and Reproductive Health and Research at WHO and head of the United Nations Special Programme of Research, Development and Research Training in Human Reproduction (HRP), called for accessibility of such solutions across the world.
She stated, “Postpartum hemorrhage is scary, not always predictable, but absolutely treatable. Nonetheless, its impacts around the world are tragic. No woman should fear for her life when giving birth. Effective solutions to tackle postpartum bleeding need to be available and accessible so that all women can experience a safe birth and a healthy future with their families.”
Currently, a major challenge in responding to PPH is that it is often detected too late to respond effectively. Most providers use visual inspection to assess bleeding, which tends to underestimate blood loss and can lead to life-threatening delays in treatment.
When treatment is provided, it is typically done in a sequential manner with gaps between each intervention, costing more time if the first options are not effective. The recommended E-MOTIVE package includes early and accurate detection of PPH using a blood-collection drape.
This is complemented by an immediate treatment bundle where indicated, including uterine massage, medicines to contract the womb and stop the bleeding, intravenous fluid administration, an examination, and, when needed, escalation to advanced care.
In the trial, the E-MOTIVE intervention was supported with an implementation strategy consisting of specific training, PPH trolleys or carry cases, engagement of local champions, audits, and feedback. All components of the E-MOTIVE intervention can be performed by midwives.
