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Getting an evidence-based post-partum haemorrhage policy into practice.

Carolyn A Cameron1, Christine L Roberts, Jane Bell

  • 1Centre for Perinatal Health Services Research, School of Public Health, University of Sydney, New South Wales, Australia. carolyn.cameron@med.usyd.edu.au

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Many hospitals lack the resources and training to implement post-partum haemorrhage (PPH) policies effectively. Standardized monitoring is crucial for early PPH detection and consistent care across all maternity facilities.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal Health
  • Healthcare Policy

Background:

  • Post-partum haemorrhage (PPH) affects up to 10% of births, posing a significant risk to maternal health.
  • A 2002 NSW Department of Health (DoH) policy aimed to standardize PPH prevention and management.
  • Maternity units reported insufficient skills and resources for developing required local protocols.

Purpose of the Study:

  • To assess the implementation of the NSW Department of Health's PPH Framework.
  • To identify barriers and enablers to developing local PPH policies in NSW maternity hospitals.

Main Methods:

  • A survey of all 96 NSW childbirth facilities.
  • Semistructured telephone interviews with senior midwives.

Main Results:

  • 94% of hospitals had PPH policies, with 83% updated after the Framework's release.
  • 22% of policies contained incorrect PPH definitions; only 71% of rural/district hospitals recalled receiving the Framework.
  • Barriers included resources, entrenched practices, and centralized policy; enablers were relationships, the Framework, education, and time.

Conclusions:

  • Hospitals require more support to develop locally relevant PPH policies.
  • NSW DoH policy directives need to accommodate varying hospital care levels.
  • Routine, consistent post-partum monitoring is recommended for earlier PPH recognition statewide.