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Controlling postpartum hemorrhage after home births in Tanzania
N Prata1, G Mbaruku, M Campbell
1Bixby Population Program, School of Public Health, University of California, Berkeley, 1213 Tolman Hall, Berkeley, CA 94720-1690, USA. ndola@berkeley.edu
Objectives:
Determine safety of household management of postpartum hemorrhage (PPH) with 1000 microg of rectal misoprostol, and assess possible reduction in referrals and the need for additional interventions.
Methods:
Traditional birth attendants (TBAs) in Kigoma, Tanzania were trained to recognize PPH (500 ml of blood loss). Blood loss measurement was standardized by using a local garment, the "kanga". TBAs in the intervention area gave 1000 microg of misoprostol rectally when PPH occurred. Those in the non-intervention area referred the women to the nearest facility.
Results:
454 women in the intervention and 395 in the non-intervention areas were eligible. 111 in the intervention area and 73 in the non-intervention had PPH. Fewer than 2% of the PPH women in the intervention area were referred, compared with 19% in the non-intervention.
Conclusion:
Misoprostol is a low cost, easy to use technology that can control PPH even without a medically trained attendant.
