Every six minutes, a mother in a developing country dies from losing blood while giving birth. With the right treatment, we can ensure more babies grow up with their mums.
Postpartum haemorrhage (PPH) is the leading cause of maternal deaths worldwide, mainly in developing countries. From Autumn 2020 researchers based at the University of Birmingham started a groundbreaking trial across 80 health facilities in South Africa, Kenya, Nigeria, Tanzania and Sri Lanka. The trial, called the E-MOTIVE study, aims to reduce severe bleeding after birth and ultimately reduce maternal deaths by 25%.
High-quality childbirth care from expert healthcare professionals is available for all mothers in the UK. Tried and tested methods for dealing with severe bleeding after birth are applied consistently if a new mother starts to bleed after childbirth. Yet for women in low- and middle-income countries, delayed detection and inconsistent treatment make postpartum haemorrhage highly dangerous.
Early detection and effective treatment are limited and new interventions are urgently required. Developing a package of care to help diagnose bleeding early and treat women quickly can make the difference between life and death.
The University of Birmingham, supported by a $10.9 million grant from the Bill and Melinda Gates Foundation, is leading a global effort to tackle bleeding after childbirth. Led by Professor Arri Coomarasamy (MBChB Medicine, 1995; MD Obstetrics and Gynaecology, 2004), a renowned Professor of Gynaecology and Reproductive Medicine and the Director of the WHO Collaborating Centre for Global Women’s Health, and Dr Ioannis Gallos, Senior Clinical Lecturer, the University team will conduct the E-MOTIVE study, to detect and treat mothers suffering from postpartum haemorrhage.
The E-MOTIVE intervention consists of an early detection strategy for PPH based on objectively measuring blood loss, to ensure that a ‘first response PPH treatment bundle’ is promptly triggered for maximum benefit. The first response bundle includes uterine massage, specialist drugs (oxytocin and tranexamic acid) and fluids. This practical bundle of care is supported by a robust implementation strategy, focusing on simulation-based training, peer-assisted learning and local champions.
The study aims to generate the necessary evidence to give healthcare practitioners and policy-makers the confidence to implement and scale-up the programme, moving us closer to having an implementable pathway to stopping these preventable deaths occurring. Thank you to everyone who supported Arri’s work on preventing miscarriages in 2017.