Pregnancy and childbirth

For women in some low-income countries, the risk of dying from pregnancy or childbirth can be as high as 1 in 17. For every woman who dies, there are 30 more who suffer a disability as a result of pregnancy or childbirth. These can be serious, lifelong ailments that compromise a woman’s health, productivity and quality of life.

Making birth safer

The Bixby Center’s Safe Motherhood Program is working to make childbirth safer for women around the world by promoting women’s health and human rights. The program conducts rigorous research and translates findings into knowledge for providers globally, while also creating links between research, policy and implementation. For instance, the Safe Motherhood Program pioneered use of the non-pneumatic anti-shock garment (NASG) as a first-aid device to stabilize women who are suffering from obstetric hemorrhage and shock. This is the leading cause of maternal death during which a woman bleeds heavily, most often after giving birth. One woman in the world dies every four minutes from this complication. The NASG can be applied by anyone after a short, simple training and has been used to help more than 10,000 women reach lifesaving medical care in more than 33 countries.

Bixby researchers designed and tested a simple tool that saves women’s lives when they continue to bleed after birth, called the Non-pneumatic anti-shock garment or NASG. Our research contributed to an international agreement to significantly reduce the cost of NASGs so they can reach more women in need.


Our researchers are evaluating the use of an inexpensive and easy-to-use pill, misoprostol, to prevent obstetric hemorrhage. The Bixby Center is leading studies to examine the use of the NASG and misoprostol in various health care settings around the world in order to enhance their safe and effective use, to improve service delivery and providers' acceptance of the technologies, and to save women’s lives globally.

Another focus is emergency obstetric and neonatal training for healthcare providers. Together with collaborators at the University of Utah and PRONTO International, our researchers are evaluating the impact of an innovative training model for provider teams. The program originated in Mexico with implementation trials underway or planned there and in Guatemala, India and Kenya.

Treating complications of birth

The Safe Motherhood Program is researching the most effective ways to prevent and treat obstetric fistula, a hole in the birth canal due to prolonged obstructed labor. Each year, as many as 100,000 women worldwide develop obstetric fistula, which can lead to constant incontinence, shame, social segregation and disability. In collaboration with colleagues in Uganda and with obstetrical surgeons at UCSF, we are leading mixed-methods research on post-surgical reintegration among women whose obstetric fistulas have been surgically repaired.