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Promoting Safe Motherhood through Simple, Life-Saving Interventions

Laxmi's Story

"I'll never forget Laxmi, a young mother who bled excessively from life-threatening hemorrhage after giving birth at home," recalled Dr. Setara Rahman, Senior Program Officer at EngenderHealth's Bangladesh Country Office. "The traditional birth attendant and her family did not know what to do. After a terrifying five hours, Laxmi's family finally brought her to the hospital where she received two liters of blood and underwent surgery. Fortunately, Laxmi made it to the hospital in time... many women aren't so lucky."

Laxmi almost lost her life due to postpartum hemorrhage—excessive bleeding during the first 24 hours after birth. Though such bleeding cannot be predicted, risk factors for it include poor health status, lack of access to a skilled birth attendant, delayed decision making by heads of households, and poor referral networks within communities and across health care facilities. While these factors are difficult to overcome, the good news is that postpartum hemorrhage is largely preventable through simple interventions.

Hope in Prevention
While Laxmi was able to receive life-saving treatment in time, preventing postpartum hemorrhage from occurring is critical. To address this issue, EngenderHealth is collaborating in an innovative global partnership, the Prevention of Postpartum Hemorrhage Initiative (POPPHI), to promote "active management of the third stage of labor" (AMTSL)—a simple, proven, low-cost intervention that health care providers can perform on every woman at every birth to help prevent postpartum hemorrhage. AMTSL involves three simple steps—providing a drug that stimulates contractions after birth, delivering the placenta, and massaging the uterus.

Consistent practice of AMTSL can mean the difference between life and death. Unfortunately, AMTSL is vastly underutilized by health care providers worldwide because they don't know about it, clinical guidelines are outdated, or necessary medicines and supplies are simply not available.

Preventing Deadly Bleeding in Bangladesh
In Bangladesh, EngenderHealth is undertaking various activities to prevent postpartum hemorrhage by identifying clinical and facility based barriers to AMTSL; by advocating with local partners to develop and adapt simple policy and service-delivery guidelines; and by raising awareness among health care providers and communities about the importance of preventing postpartum hemorrhage.

Partnerships such as POPPHI are making a difference by offering simple tools and knowledge to prevent postpartum hemorrhage, save lives, and reduce strains on public health systems. The success of this project will mean that Laxmi and the thousands of women like her have a better chance at health and survival.

Launched in 2004, the Prevention of Postpartum Hemorrhage Initiative involves EngenderHealth, the Program for Appropriate Technologies in Health (PATH), and RTI International.

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