Confronting Maternal Mortality Due to Postpartum Hemorrhage and Unsafe Abortion: A Call for Commitment

In this commentary co-authored by VSI and the Regional Experts' Summit Group, 35 ob/gyns and public health experts from 12 countries in Africa call for political commitment to expanding access to misoprostol for its many uses in maternal health.

Provision of injectable contraceptives in Ethiopia through community-based reproductive health agents

This collaborative project demonstrates that receiving injectable contraceptives from community-based reproductive health agents proved as safe and acceptable to Ethiopian women as receiving them in health posts from health extension workers. These findings support the development, introduction and scale-up of programs to train community-based health workers to safely administer injectable contraceptives.

Community mobilization to reduce postpartum hemorrhage in home births in northern Nigeria

Focusing on the community-oriented approach, this article highlights the successful results of an operations research program assessing the safety and feasibility of community-based distribution of misoprostol for prevention of postpartum hemorrhage (PPH) in five communities around Zaria, Nigeria.

Cost-effectiveness of misoprostol to control postpartum hemorrhage in low-resource settings

2007 publication in the International Journal of Gynecology & Obstetrics

This paper discusses the cost-effectiveness of training traditional birth attendants to recognize postpartum hemorrhage (PPH) and administer a rectal dose of misoprostol in areas with low access to modern delivery facilities through modeling two hypothetical cohorts of 10,000 women.

The Role of Misoprostol in Scaling Up Postabortion Care

This letter, published in International Perspectives on Sexual and Reproductive Health, presents the benefits of misoprostol for use in treating incomplete abortion. Its relative ease of use for this indication and cost-effectiveness, render misoprostol a key tool for scaling up access to postabortion care services in remote areas where deaths from unsafe abortion are common.

Saving Maternal Lives in Resource-Poor Settings

Facing Reality

This 2009 article published in Health Policy evaluates safe-motherhood interventions suitable for resource-poor settings that can be implemented with current resources.

Inability to predict postpartum hemorrhage: insights from Egyptian intervention data

Knowledge on how well we can predict primary postpartum hemorrhage (PPH) can help policy makers and health providers design current delivery protocols and PPH case management. This article, published in BMC Pregnancy & Childbirth, demonstrates that no single factor can reliably predict the risk of hemorrhage after delivery and therefore supports the development of research, policy work and scale-up of prevention efforts for PPH.

Prevention of Postpartum Hemorrhage

Options for Home Births in Rural Ethiopia

This paper sought to determine the safety and feasibility of home-based prophylaxis of postpartum hemorrhage (PPH) with misoprostol, including assessment of the need for referrals and additional interventions.

Community-Based Availability of Misoprostol

Is It Safe?

This paper evaluates the safety and acceptability of long-term community-based use of misoprostol for management of postpartum hemorrhage (PPH) in home-births, by comparing deliveries with and without misoprostol use in communities of Kigoma, Tanzania.

Prevention of postpartum hemorrhage at home births in Afghanistan

Averting Maternal Death and Disability

Led by researchers at Jhpiego, this article demonstrates the safety, acceptability, feasibility and program effectiveness of self-administered misoprostol for prevention of postpartum hemorrhage at home births in Afghanistan.  VSI Medical and Programs Director, Dr Ndola Prata, was a co-author on this 2010 publication in the International Journal of Gynecology and Obstetrics.

Misoprostol for Safe Motherhood

One tablet, two life-saving indications

This 2010 article published in the African Journal of Midwifery presents an evaluation of the cases of postpartum hemorrhage (PPH) and need for additional interventions after the introduction of misoprostol for PPH in public facilities in Zanzibar.