Controlling postpartum hemorrhage after home births in Tanzania

Objectives: Determine safety of household management of postpartum hemorrhage (PPH) with 1000 μg of rectal misoprostol, and assess possible reduction in referrals and the need for additional interventions. Methods: Traditional birth attendants (TBAs) in Kigoma, Tanzania were trained to recognize PPH (500 ml of blood loss). Blood loss measurement was standardized by using a local garment, the “kanga”. TBAs in the intervention area gave 1000 μg of misoprostol rectally when PPH occurred. Those in the non-intervention area referred the women to the nearest facility. Results: 454 women in the intervention and 395 in the non-intervention areas were eligible. 111 in the intervention area and 73 in the non-intervention had PPH. Fewer than 2% of the PPH women in the intervention area were referred, compared with 19% in the non-intervention. Conclusion: Misoprostol is a low cost, easy to use technology that can control PPH even without a medically trained attendant.