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.