Celebrate Solutions: Haitian Midwives Use Next-Generation Birth Kit to Prevent Postpartum Hemorrhage

By: Rati Bishnoi, Special Projects Intern at Women Deliver

The most recent graduates from Midwives for Haiti are some of the first health professionals on the island nation to use an obstetric kit specially equipped to prevent death from excessive bleeding after childbirth.

Across the world, postpartum hemorrhage is the leading cause of maternal death followed closely by sepsis, obstructed labor, hypertensive disorders of pregnancy and complications from unsafe abortion. Approximately 35 percent or 112,500 of all maternal deaths each year are estimated to be caused by postpartum hemorrhage.
 
The Maternova Obstetric Kits features a set of simple tools that can easily be carried in a suitcase or backpack and hung like a toiletry bag during deliveries. These tools include:
•    a device for measuring postpartum blood loss;
•    a test to detect anemia;
•    a chart listing the three basic steps of the Active Management of the Third Stage of Labor or AMTSL protocol;
•    a solar-powered headlamp; and
•    a winnable-mobile phone charger.

This kit is just one of the many ways in which Maternova, a U.S.-based organization committed to “moving maternal and newborn care into the 21st century,” is connecting health care professionals with innovative, effective, and low-cost tools that have the power to save mothers and children.  

By gifting obstetric kits to the some of Haiti's newest midwives, Maternova is trying to bring this innovation to the girls and mothers of the country with the highest maternal mortality rate in the Western Hemisphere. In Haiti, almost one in 93 women die during childbirth and only 26 percent deliver with the support of a skilled birth attendant.

According to Maternova, the obstetric kit represents the “next-generation” of birth kits that are designed to improve care by addressing a wider range of maternal health issues. For example, clean birth kits support midwives in achieving the six main clean birth practices, which include ensuring hands, the perineum, delivery surface, and the cord-cutting, cord-tying, and cord-care processes are clean, to preventing infections following childbirth. However, these practices and elements of clean birth kits—such as soap, a clean blade, and a clean thread—do not prevent postpartum hemorrhage.

The kits delivered to the midwives in Haiti include a plastic under-buttocks drape, which features a calibrated measuring funnel. The funnel helps midwives more precisely assess blood loss and avoid basing care decisions on visual estimation, which is shown to consistently underestimate blood loss and worsen the chance of death because of postpartum hemorrhage. Midwives can also bleach and re-use the plastic drape in other deliveries.

Testing for anemia is also quicker and more precise. Using the obstetric kit, midwives can place one drop of blood on a test strip and comparing the final color to the World Health Organization’s Haemoglobin Colour Scale  to determine if a new mother is lacking healthy red blood cells.

In addition to supporting better care delivery, the kit also focuses on improving the safety of midwives. The solar-powered headlamp not only helps provide essential light during nighttime deliveries, but it also helps midwives stay protected in remote rural areas or refugee camps. Similarly, a charged cellphone gives midwives a lifeline to call for help during times of danger or obstetric emergencies.

These often-overlooked dimensions of being a health care worker is captured by Maternova because the organization places an emphasis on feedback from practitioners. According to Maternova Founder Meg Wirth, the obstetric kit continues to evolve. So far, the obstetric kit has been tested by midwives and obstetricians in Mali, Liberia, Zambia, Kenya, Tanzania, Uganda, Palestine, Honduras, Haiti and China, and will soon be tested by midwives in Pakistan and South Africa.

Photo via Maternova