Misoprostol to Reduce Postpartum Hemorrhage

Each year, over half a million women die in pregnancy and childbirth. The largest single cause of these deaths is postpartum hemorrhage (PPH). A woman who suffers from excessive bleeding after childbirth can die in as little as two hours unless she receives immediate and appropriate care. In Africa and Asia, where many women continue to give birth at home or in under-equipped and over-burdened facilities, PPH is estimated to be responsible for over 30% of maternal deaths.

To help prevent and treat PPH in low-resource settings, PSI promotes, distributes and trains providers in the safe use of Misoprostol, a drug effective in reducing postpartum bleeding. Misoprostol is a generically available prostaglandin that reduces the risk of postpartum hemorrhage when administered orally, immediately after birth. It can also be used to treat PPH.

Misoprostol is safe and effective, relatively inexpensive and causes few side effects. Misoprostol is heat-stable and comes in tablet form, meaning it does not require refrigeration, nor must it be administered via injection or IV- unlike other drugs used to prevent or treat PPH. As a result of these qualities, misoprostol has incredible potential to reach women in resource-limited settings. In many developing countries, medical facilities, particularly at the secondary and tertiary levels, are not always equipped with cold chain storage nor do they always have skilled providers on-site. Additionally, large numbers of women in the developing world continue to give birth outside of a facility and/or without the attendance of a skilled provider. Providing a drug that can reduce the risk of PPH for women in these settings is an important step to reducing maternal mortality globally.

Use of misoprostol for prevention of PPH in resource-limited settings is supported by the International Federation of Gynecology and Obstetrics (FIGO), the Prevention of Postpartum Hemorrhage Initiative (POPPHI), the United States Pharmacopeia, and the World Health Organization.

PSI operates misoprostol for PPH programs in Nigeria, Somaliland, Tanzania, Uganda and Zambia. Additionally, PSI contributes to partner programs for misoprostol for PPH in Mozambique.

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Health Areas: Reproductive Health