We promote, distribute and train providers in the safe use of misoprostol, a drug effective in reducing postpartum bleeding.
Each year an estimated 287,000 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. More than 220 women bleed to death after childbirth every day. 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 approximately 30 percent of all maternal deaths.
To help prevent and treat PPH in low-resource settings, we promote, distribute and train providers in the safe use of misoprostol, a drug effective in reducing postpartum bleeding. Misoprostol is now recommended by the World Health Organization (WHO) for prevention and treatment for PPH in circumstances where the firstline drug, Oxytocin, is not available.
Qualities of misoprostol
- It 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.
- It 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, and it does not have to 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 International Confederation of Midwives (ICM), the Prevention of Postpartum Hemorrhage Initiative (POPPHI), the United States Pharmacopeia and WHO.
Making a difference
Twenty-year-old Muti Kapungo gave birth to her second child at home in Luko, Zambia. She had planned on delivering in a facility; however, upon arriving at Litoya Rural Health Centre in labor she was informed all the health providers had gone elsewhere.
Muti returned home and had her husband call the traditional birth attendant. During her last antenatal visit, her health provider had given her three misoprostol tablets and instructed on how to use them.
“After the baby was born, I told the birth attendant to give me the three tablets from the plastic bag before the placenta came out,” says Muti. “After I took the pills, I did not bleed as much as in my last delivery and I did not have a problem with the placenta taking long to come out either. When I settled and was feeding the baby, the birth attendant asked me about the tablets, and I explained that I got them at the clinic in Mongu to prevent excessive bleeding after delivery. I would recommend this pill to other women.