KWA-ZULU NATAL, South Africa — The World Health Organization (WHO), in collaboration with the University of Birmingham, has released a study demonstrating the effectiveness of a new intervention to fight maternal mortality in poor countries by reducing Postpartum Hemorrhage (PPH). Here is everything you need to know about maternal mortality, PPH, and how E-MOTIVE could make a difference.
Maternal Mortality: The Facts
Every two minutes, a mother loses her life to pregnancy or childbirth complications, amounting to 287,000 maternal deaths in 2020 alone. This tragedy disproportionately affects low and lower-middle-income countries, which account for nearly 95% of all maternal deaths.
Reducing maternal mortality is at the forefront of the United Nations’ Sustainable Development Goals. By 2030, it aims to reduce the current global average of 223 maternal deaths per 100,000 live births to a mere 70. That will be harder in some regions, such as Sub-Saharan Africa, which has a maternal mortality rate more than double the global average at 545 deaths per 100,000 live births.
What Is Postpartum Hemorrhage?
Postpartum Hemorrhage is the leading cause of maternal mortality worldwide, claiming 70,000 lives annually. That’s a mother’s death every six minutes.
PPH occurs when a mother loses more than half a liter of blood within 24 hours of giving birth, equivalent to more than 10% of her total blood supply. It is curable with swift detection and treatment. Unfortunately, healthcare providers often underestimate blood loss or respond too slowly, leading to dire consequences.
Introducing E-MOTIVE: Revolutionizing PPH Treatment
E-MOTIVE is a new strategy for combating PPH, particularly in underserved regions. It has three components: early detection, WHO’s recommended first-response treatments for PPH (MOTIVE), and practical implementation.
‘E’ Is for Early
The “E” in E-MOTIVE emphasizes the promotion of early PPH detection. Using a simple, conical collection device called a drape, practitioners can objectively measure blood loss in the first few hours after childbirth. The drape incorporates ‘trigger lines’ at 300ml and 500ml of blood loss, telling healthcare staff exactly when they should begin treating for PPH.
E-MOTIVE adopts WHO’s recommended first-response treatments for PPH, abbreviated as MOTIVE. This comprehensive approach includes:
- Uterine massage
- Oxytocic drugs
- Tranexamic acid
- IV fluids
- Examination and (if necessary) escalation
Rather than implementing these interventions sequentially, E-MOTIVE encourages bundling them together, reducing time-consuming trial-and-error approaches.
Healthcare facilities in underserved regions don’t have time, staff or resources to spare. To impact the places that need it most, E-MOTIVE must be practical and cost-effective. Hence, the E-MOTIVE strategy promotes peer-to-peer training and the availability of pre-packed E-MOTIVE trolleys or carry cases. Moreover, midwives can do everything that E-MOTIVE promotes without assistance from doctors or nurses, reducing reliance on specialists. In its study, WHO also found that E-MOTIVE reduces the need for expensive blood transfusions because of its early detection component.
What E-MOTIVE Means for Underserved Mothers
After a 16-month trial involving over 200,000 women in Kenya, Tanzania, Nigeria and South Africa, E-MOTIVE proved remarkably effective. The PPH detection rate increased from just over 50% to more than 90% in healthcare facilities employing E-MOTIVE. There were fewer PPH fatalities and a 60% decrease in severe bleeding (defined as losing over a liter of blood).
Time will tell whether E-MOTIVE proves effective in the long term. But there is reason to believe that this groundbreaking solution for postpartum hemorrhage could be the breakthrough that underserved regions have been eagerly anticipating.
– Faye Crawford