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Kampala, Uganda | THE INDEPENDENT | A study published today by researchers from the World Health Organization (WHO) and the University of Birmingham suggests that a new solution called E-MOTIVE could be a major breakthrough in reducing deaths related to bleeding during childbirth.
Postpartum hemorrhage (PPH), defined as the loss of more than 500 mL of blood within 24 hours after birth, is a leading cause of maternal mortality worldwide, affecting an estimated 14 million women each year and resulting in around 70,000 deaths, mostly in low- and middle-income countries, equivalent to one death every 6 minutes.
The researchers enrolled over 200,000 women from four countries in a study, in which they found that measuring blood loss using a simple, low-cost collection device called a “drape” and bundling together WHO-recommended treatments, rather than offering them sequentially, resulted in dramatic improvements in outcomes for women.
Severe bleeding, which involves a woman losing more than a liter of blood after birth, was reduced by 60%, and women were less likely to die. There was also a substantial reduction in the rate of blood transfusions for bleeding, which is of particular importance in low-income countries where blood is a scarce and expensive resource.
Experts believe that this new approach to treating postpartum hemorrhage could radically improve women’s chances of surviving childbirth globally, helping them get the treatment they need when they need it. Professor Arri Coomarasamy, who led the trial and is the Co-Director of the WHO Collaborating Centre on Global Women’s Health at the University of Birmingham, commented that time is of the essence when responding to postpartum bleeding, and interventions that eliminate delays in diagnosis or treatment should 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.
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