This Sunday—Mother’s Day in the United States—will be a day of light hearts and laughter for many. At PATH, we’re dedicated to developing simple, affordable technology to make sure becoming a mother is a time of joy the world over.
In some parts of the world—notably sub-Saharan Africa—childbirth remains an extremely dangerous time in a woman’s life. Some 300,000 women worldwide die each year just before or after delivery. Excessive obstetric bleeding—postpartum hemorrhage—causes 1 in 4 of these deaths. And mothers who survive aren’t out of danger. Those who live through severe postpartum hemorrhage are significantly more likely than other mothers to die within a year’s time, leaving their babies and families alone.
Elizabeth Abu-Haydar, a public health specialist with our Technology Solutions program, looks for ways technology can make childbirth safer. On May 28, she’ll be presenting her work at Women Deliver, an international conference focused on improving the health and well-being of girls and women. To celebrate Mother’s Day, we asked Elizabeth about some of the technologies that hold promise for making childbirth safer.
What will you talk about at Women Deliver?
I’m going to highlight some of the technologies we’re working on to fill a gap that occurs when women experience severe postpartum hemorrhage. There’s a clear protocol that’s followed when a woman starts bleeding after delivery: She’s given medication and her abdomen is massaged, and in 62 percent of the cases, that works to stop the bleeding. But in those other roughly 40 percent of cases, the woman could potentially continue bleeding—and if she’s bleeding severely, even a healthy woman can die within two hours. Most of these women are not as healthy as they could be, and the biggest problem is that many of them are anemic.
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Why does anemia make the problem worse?
These women have low iron stores, and the body during pregnancy requires more iron. If a woman starts bleeding and she doesn’t have iron stores, she’s likely to go into heart failure and shock much more rapidly than a woman who is healthy. In sub-Saharan Africa, where 40 to 50 percent of the women are anemic, that’s a huge problem.
What can we do about it?
We’ve been testing a device that makes it very easy to assess whether a woman is iron deficient or not. We call it a noninvasive anemia screening device. The device measures iron levels using a clip that attaches to the woman’s finger. Ideally, you would use it every time she comes in for her prenatal visit. If there’s a problem, you can start treatment and monitoring. The screening doesn’t require blood, it gives a reading in less than a minute, it doesn’t hurt, and it’s visual, so that it becomes a way to talk about iron with the woman. Plus, there are no sharps and no waste and no resupply issues either, which is a big, big deal.
What do you do to stop the bleeding once it starts?
One option is the balloon tamponade. It’s basically tubing attached to a vessel, such as a condom, that is inflated by pumping water into it. It’s inserted into the uterus and filled until it stops the bleeding. It is very effective and it’s very affordable.
Another option is the antishock garment, which looks a bit like a tight wetsuit. Its main purpose is to reverse shock. If a woman has bled profusely and her organs are shutting down, she starts going into shock. That’s when the antishock garment gets wrapped around her in a sequential manner starting from her legs up so that the blood is pushed to her vital organs. You can combine the antishock garment with the balloon tamponade. It’s a beautiful combination!
You sound very motivated—even though developing technologies is a long haul. What keeps you going?
You know, I was in Kenya in August, visiting 13 clinics that were run by midwives—not fancy, these were serving the slums of Nairobi. We talked about the balloon tamponade, and a couple of midwives had used it. They talk about the woman who came in to give birth, and they really thought she was going to die, and there was no way she was going to make it to the hospital, and somebody said, “Why don’t we use this balloon thing they were telling us about?” And they try it. And the woman survives. And she comes back a week later with her baby. That inspires me. That’s very exciting, I think.