COLLABORATIVE APPROACH FOR COLLABORATIVE APPROACH FOR THE TREATMENT OF THE TREATMENT OF

POSTPARTUM HAEMORRHAGE POSTPARTUM HAEMORRHAGE

FLASOG : FLASOG : May 2005May 2005Betty-Anne Daviss, RM, MABetty-Anne Daviss, RM, MA

Project Manager, ICM/FIGO, Iniciativa Maternidad Sin Project Manager, ICM/FIGO, Iniciativa Maternidad Sin Riesgo/Newborn Riesgo/Newborn

Iniciativa Global en la Prevencion de la hemorragia Post-Iniciativa Global en la Prevencion de la hemorragia Post-PartoParto

The Swedish Association of Midwives The Swedish Association of Midwives

Centers for Disease Control & Prevention. Achievements in Public Health 1900-1999: Healthier Mothers and Babies; 48(38):849-58; Atlanta, 1999.

WHO Maternal Mortality in 2000: estimates developed by WHO, UNICEF & UNFPA; Geneva, 2002

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maternal mortality’s unfinished agenda in the Americas

maternal mortality’s unfinished agenda in the Americas

HAI

BOLPER

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PARPANTRTDORELS

COLECUHON

VENBARJAMMEXARG BAH

CORCUBCHIURU

CANLAC

Important measure to reduce Important measure to reduce maternal mortalitymaternal mortality

• In developed countries it has been shown that In developed countries it has been shown that the development of national midwifery the development of national midwifery coverage has often been the single most coverage has often been the single most important measure in reducing maternal important measure in reducing maternal mortality. mortality.

Jerker Liljestrand,Jerker Liljestrand, Co-chair, Safe Co-chair, Safe

Motherhood Program, Motherhood Program, FIGO FIGO

Women do not always come to the Women do not always come to the clinics. clinics.

Key Components of FIGO/ICM Key Components of FIGO/ICM Safe Motherhood/Newborn Safe Motherhood/Newborn ProjectsProjects• 1. Civil Society1. Civil Society

• 2. Midwives’ & Nurses’ Associations2. Midwives’ & Nurses’ Associations

• 3. Obstetric Societies3. Obstetric Societies

• 4. Ministries of Health4. Ministries of Health

Latin America and the Latin America and the Carribean:Carribean:Causes of Maternal MortalityCauses of Maternal Mortality• Hemorrhage (20%),Hemorrhage (20%),

• Toxemia (22%)Toxemia (22%)

• Other complications post partum (15%)Other complications post partum (15%)

• Other direct causes (17%). Other direct causes (17%).

• Abortion related deaths 11% (in some countries, abortions leading cause)Abortion related deaths 11% (in some countries, abortions leading cause)

• Pre-existing diseases (15%) ( tuberculosis, heart disease, and influenza) Pre-existing diseases (15%) ( tuberculosis, heart disease, and influenza) management.management.

•

• Based on PAHO data (1995-2000) for reported maternal deaths in 20 countries, using various Based on PAHO data (1995-2000) for reported maternal deaths in 20 countries, using various sources, primarily vital statistics, surveillance, and special country studies. Under-reporting is still a sources, primarily vital statistics, surveillance, and special country studies. Under-reporting is still a problem in many countriesproblem in many countries

Every attendant at birth needs to Every attendant at birth needs to have the knowledge, skills and have the knowledge, skills and critical judgment needed to carry critical judgment needed to carry out active management of the out active management of the third stage of labour and access third stage of labour and access to needed supplies and to needed supplies and equipment.equipment.

Joint StatementManagement of the Third Stage of Labour to Prevent Post-partum

Haemorrhage

GUATEMALA 2002GUATEMALA 2002

Hemorrhage53%

Sepsis14%

Eclampsia12%

Abortion10%

O ther Direct3%

Indirect8%

Parteras Empiricas – Parteras Empiricas – MisoprostolMisoprostol

Health Clinic Manager -- Health Clinic Manager -- AfghanistanAfghanistan

Learning How to Use Learning How to Use OxytocinOxytocin

Alerta Internacional Alerta Internacional Asociación de Ginecologia y Asociación de Ginecologia y

Obstetricia de GuatemalaObstetricia de Guatemala