Safe Motherhood Programs

What is Safe Motherhood?
The Safe Motherhood Initiative is a worldwide effort that aims to reduce the number of deaths and illnesses associated with pregnancy and childbirth. Ways to achieve safe motherhood include:

    • Skilled attendance at all births
    • Access to quality emergency obstetrical care
    • Access to quality reproductive health care, including family planning and safe post-abortion care

Why Safe Motherhood?
Maternal mortality is a major cause of death and disability among women of reproductive age. 500,000 women die every year from complications related to childbearing. Many more women are injured, some severely, from childbirth complications. Maternal mortality and morbidity adversely affect the health and welfare of children, families, and communities.

Where is Safe Motherhood relevant?
Maternal mortality is the leading cause of death for women of reproductive age in Asia and Latin America. It is the second leading cause of death for women in Africa. Causes of maternal mortality include:

    • Hemorrhage
    • Sepsis
    • Obstructed Labor
    • Complications of Abortion

Advances in Hemorrhage Prevention and Treatment
Hemorrhage is the leading cause of maternal mortality, but advances in the prevention and treatment of hemorrhage are being made and include:

    • Recognition of when normal blood loss of pregnancy becomes too much
    • Transportation and referral systems to get women from home or a primary health care center to emergency obstetric care
    • Active management of third stage labor
    • Use of uteronics for prevention and treatment of uterine atony
      • Misoprostol oral and/or rectal
      • Oxytocin
      • Oxytocin in Uniject
    • Non-pneumatic Anti-Shock Garment to treat shock, resuscitate, stabilize, and prevent further bleeding in women with ANY form of obstetric hemorrhage


The Non-pneumatic Anti-Shock Garment (NASG)

What is it?
The NASG is a simple neoprene and Velcro device much like the bottom half of a wet suit split down the middle.

How does it work?
When in shock, the brain, heart, and lungs are deprived of oxygen because blood accumulates in the lower abdomen and legs. The NASG reverses shock by returning blood to the vital organs. This will restore the woman’s consciousness, pulse, and blood pressure. Additionally, the NASG slows blood flow to the lower body and decreases bleeding.

How is the NASG used?
After a simple training session, anyone can put the garment on a bleeding woman. Once her bleeding has stopped, she can be safely transported from a home birth or primary health care center to a referral facility for emergency obstetrical care. 

Preliminary results of the NASG study
In the pilot Egypt study, bleeding of women who were suffering from various forms of obstetrical hemorrhage (e.g. ruptured ectopic pregnancy, post-abortion complications, post-partum hemorrhage) and were put in the NASG decreased by 50% as compared with women in the control group who did not use the NASG.


Bixby Center Safe Motherhood Projects

    1. NASG studies in Egypt, Nigeria, Zimbabwe, and Zambia

    2. Continuum of Care Projects in Nigeria and India

    3. Millennium Development Villages in Ghana, Kenya, Ethiopia, Uganda, and Nigeria

    4. Infectious diseases and maternal health in Kenya

    5. Peri-natal infections among pregnant women in Afghanistan

    6. Near-miss maternal mortality in Afghanistan


For more information on Safe Motherhood Programs or the NASG, please contact Suellen Miller or go to www.lifewraps.org.


New! The 2008 Safe Motherhood Programs Update.



Safe Motherhood Publications

 

2006            Miller, S, Hamza, S, Bray E, Gipson R, Nada, K, Fathalla, M, Mourad, M, et al. First Aid for Obstetrical Hemorrhage: The Pilot Study of the Non-pneumatic Anti-Shock Garment (NASG) in Egypt. BJOG, 113(4):424-9.

2006            Miller, S, Turan, JM, Ojengbede A, Ojengbede, O, Fathalla, M, Morhason-Bello, IO, Mourad, M, Galandanci, H, Hamza, S, Awaal, M, Akinwuntan, A, Mohammed AI, McDonough, L, Dau, K, Butrick, E, and Hensleigh, P. The Pilot Study of the Non-pneumatic Anti-Shock Garment (NASG) in Women with Severe Obstetric Hemorrhage: Combined Results from Egypt and Nigeria. Int J Gynaecol Obstet, 94(S3):s43-s44.

2006            Tudor, C, Miller, S, Nyima, Sonam, Varner, M. Preliminary progress report: Randomized double blind trial of Zhi Byed 11, a Tibetan traditional medicine, versus misoprostol to prevent postpartum hemorrhage in Lhasa, Tibet. Int J Gynaecol Obstet, 94(S3):s27-s29.

2006            Miller, S, Hensleigh, P. Non-pneumatic Anti-shock Garment for Obstetric Hemorrhage. Book Chapter, in International Federation of Obstetrics and Gynecology (FIGO) Book, Postpartum Hemorrhage: New Thoughts, New Approaches, Editors: C B-lynch, A LaLonde, L West, Sapiens Publications, UK.

2006            Miller, S, Turan, JM, Ojengbede A, Ojengbede, O, Fathalla, M, Morhason-Bello, IO, Mourad, M, Galandanci, H, Hamza, S, Awaal, M, Akinwuntan, A, Mohammed AI, McDonough, L, Dau, K, Butrick, E, and Hensleigh, P.  The Pilot Study of the Non-pneumatic Anti-Shock Garment (NASG) in Women with Severe Obstetric Hemorrhage: Combined Results from Egypt and Nigeria. Evidence Based Interventions to Prevent Postpartum Hemorrhage: Translating Research into Practice, Goa, India, Conference Proceedings.

2007            Miller, S, Ojengbede A, Turan J, Ojengbede O, Butrick E, Hensleigh, P.  Anti-Shock Garments for Obstetric Hemorrhage. Current Women’s Health Reviews, 3(1):3-11.

2007            Miller, S, Tudor, C, Nyima, Thorsten, V, Sonam, Droyoung, Craig, S, Le, P, Wright, L, Varner, M. Maternal and neonatal outcomes of hospital vaginal deliveries in Tibet. Int J Gynaecol Obstet, 98:217-21.

2007            Miller, S, Butrick, E, Turan, J, Ojengbede, O, Morhason-Bello, IO, Galadanci, H, Martin, H, Fabamwo, A, Solanke, O, Awwal, M, Ojengbede, A, Hensleigh, P. The Anti-Shock Garment for Post-Partum and Post-Abortion Hemorrhage in Nigeria. Conference Proceedings: Abstracts from Research Forums Presented at the ACNM 52nd Annual Meeting 2007. J Midwifery Womens Health, 52(5):531-535.

2007            Miller, S, Turan, JM, Dau, K, Fathalla M, Mourad M, Sutherland, T, Hamza, S, et al. Decreasing Maternal Mortality from Hypovolemic Shock in Low Resource Settings: the Non-pneumatic Anti-Shock Garment (NASG). Global Public Health Journal, 2(2);110-24.

2007            Adams, V, Miller, S, Craig, S, Le, PV, Samen, A, Sonam, Nyima, Droyoung, Varner, M.  Informed Consent in Cross-Cultural Perspective:  The Case of Clinical Research in the Tibet Autonomous Region, PRC. Culture Medicine and Psychiatry, 31:445-472.

2007            Miller, S, Le, P, Craig, S, Adams, A, Tudor, C, Sonam, Nyima, Droyoung, Tshomo, M, Lhakpen, Varner, M. How to Make Consent Informed: Possible Lessons from Tibet. IRB: Ethics & Human Research, 29(6):7-14.

2008            Geller, S, Adams, MG, Miller, S, A Continuum of Care Model for Postpartum Hemorrhage, In press, International Journal of Fertility & Women's Medicine.

2008            Miller, S, Tucker,C,  Martinez, Berdechevsky, K, Carlos, J. Trajectories of Acceptance:  The Introduction of the NASG in Rural Oaxaca and Puebla Mexico.  Submitted/In Revision, Soc Sci Med.

2008            Miller, S, Tudor, C, Thorsten, V, Nyima, Sonam, Droyoung, Wright, L, Varner, M. Comparison of maternal and newborn outcomes of Tibetan and Han Chinese delivering in Lhasa, Tibet. In Press, J Obstet Gynaecol Res.

2008            Turan, J,  Bukusi, E,  Cohen, C, Sande, J,  Miller, S. Effects of HIV/AIDS on maternity Care Providers on Labor and Delivery Wards in Kenya. In Press, J Obstet Gynecol Neonatal Nurs (JOGNN).

2008            Miller, S, Martin, H, Morris, J. Anti-shock Garment in Postpartum Haemorrhage. In Press, Best Pract Res Clin Obstet Gynaecol.

2007            BBC Radio interview, October 19, 2007. Dr. Miller discusses the anti-shock garment and how this low tech device can save mothers’ lives.