HMS-BAB: Helping Mothers Survive - Bleeding After Birth


2014 - 2016


Post-partum hemorrhage remains a leading cause of maternal morbidity and mortality in sub-Saharan Africa. It is estimated that up to 10% of mothers experience post-partum hemorrhage - a blood loss of > 500 ml. Around 30% of maternal deaths - 90,000 women every year - are because of severe bleeding, almost all of them in low and middle income countries.

The Active Management of the Third Stage of Labor (AMTSL), a very simple measure, can prevent severe post-partum bleeding. The most important intervention in AMSTL is the application of a uterotonic within one minute after the baby is born.


To evaluate the impact of a 1-day training in AMTSL, complemented by in-service simulator practice over a period of six weeks, on maternal morbidity and mortality due to post-partum hemorrhage. 


The cluster randomized, facility-based intervention trial will be done in 20 health districts in both Tanzania and Kenya, where half of the included districts will be assigned to the intervention arm. A most interesting aspect of this study is the use of the near-miss application to measure maternal mortality: using maternal morbidity defined as near miss', or 'a woman who nearly died by survived a complication that occured during pregnancy, childbirth, or within 42 days or termination of pregnancy'.

An information sheet with more detailed methods can be found here.


Laerdal Foundation


Senior lecturer

Claudia Hanson

Organizational unit: Global health (IHCAR)

Global Health