New innovations for preventing and treating postpartum hemorrhage are saving women's lives

May 29, 2013 by PATH

Research and analysis shows global collaboration using continuum of care approach and nonpneumatic antishock garment to address postpartum hemorrhage has positive results

Jaime-Alexis Fowler, Pathfinder, 617.407.8955,,

Kuala Lumpur, Malaysia, May 29, 2013—New research and analysis from leading global health experts at Pathfinder International, the University of California San Francisco (UCSF) Safe Motherhood Program, and PATH shows that innovative, collaborative efforts to address postpartum hemorrhage are working and expanded programming could lead to greater impact in reducing maternal mortality.

Postpartum hemorrhage, or excessive bleeding after childbirth, is the leading cause of maternal death worldwide. In 2007 at the first Women Deliver conference, Pathfinder International, UCSF, University of Illinois, Chicago, and the John D. and Catherine T. MacArthur Foundation announced an exciting partnership to address maternal mortality utilizing the nonpneumatic antishock garment, a groundbreaking technology that evolved from a suit originally developed by NASA. The garment works by applying pressure to the lower half of a woman’s body to control bleeding until she can be transported to a higher level of care. Since 2002, UCSF has led research and clinical trials for the garment’s use in treating postpartum hemorrhage.

Since that launch, Pathfinder has incorporated this unique garment in a “continuum of care” package of services in Nigeria, India, Peru, Tanzania, Burundi, and Bangladesh that emphasizes a full spectrum of care for women—addressing the quality of maternal health services by paying equal attention to all stages of postpartum hemorrhage and other causes of maternal mortality—from prevention and recognition of problems, to urgent management and referral to treatment such as surgery.

Through MacArthur-funded work in Nigeria and India, thousands of Pathfinder-trained providers have helped reduce postpartum hemorrhage in facilities through improved management of labor; treated 11,000 women with obstetric hemorrhage; and used the nonpneumatic antishock garment for nearly 1,400 women in shock. Pathfinder has also reached more than 160,000 community members in these two countries with important information on danger signs in pregnancy and planning for safe delivery.

“Working in parts of the world where distance is the difference between life and death demands solutions that can begin in the community or the home, and keep women safe at every stage,” Purnima Mane, President and CEO of Pathfinder International, said. “The continuum of care approach, combined with the nonpneumatic antishock garment does just that.”

Since 2002, the UCSF Safe Motherhood Program has focused on clinical trials and cost-effectiveness research specifically on the nonpneumatic antishock garment in low-resource settings. They have documented outcomes for over 4,000 women in hypovolemic shock in Nigeria, Egypt, Zambia, and Zimbabwe. New results from randomized clinical trials to assess the impact of utilizing the garment at primary care facilities for transfer to tertiary care centers indicate a 50 percent decrease in mortality from severe obstetric hemorrhage.

“In a cost-effectiveness study published in Public Library of Science in 2013 that used data from Nigeria and Egypt, the nonpneumatic antishock garment was highly cost-effective, averting thousands of DALYs, or death, at a cost of around $1.50/DALY averted or life saved,” Dr. Suellen Miller, Director of the Safe Motherhood Program, said. “Now we are seeing the same results in studies in Zambia and Zimbabwe at the primary care level. Essentially, if the garment is used, it saves women’s lives.”

Given the increasing results indicating effectiveness, in 2012, the World Health Organization released new recommendations that included the nonpneumatic antishock garment for use in addressing postpartum hemorrhage until appropriate care is available. WHO also recommended that national guidelines should be reviewed to ensure the nonpneumatic antishock garment is included.

To increase availability in low-resource settings, PATH has conducted new research on lowering the cost of the garment and increasing local manufacturing. PATH’s collaboration with manufacturers in India and Hong Kong has resulted in a 4 time reduction in price, while maintaining the highest standards of quality.

“Postpartum hemorrhage is a killer, but it’s also one of the few obstetric complications with proven, effective interventions, like the nonpneumatic antishock garment. To reduce costs, PATH experts are focusing on the costs of production, from raw materials through manufacturing, transport, and delivery,” said Amie Batson, Chief Strategy Officer at PATH. “These types of innovations and unique collaborations are the key to providing access to lifesaving solutions to women around the world.”

Pathfinder International, UCSF, and PATH believe that greater scale-up of the continuum of care approach, greater access to the garment at all levels of health care in low-resource areas, and lower cost of the garment, can save even more women’s lives.

“Maternal mortality is not intractable: innovation and collaboration have vital roles to play as we all accelerate our efforts to ensure every pregnancy is safe, including in emergencies," Kate Gilmore, Deputy Executive Director of UNFPA, said. “The combination of UCSF researching the garment, Pathfinder implementing its use in their proven continuum of care approach, and PATH finding lower cost manufacturing shows the importance of creative and innovative partnerships.”

About Pathfinder

For 55 years, Pathfinder International has delivered vital sexual and reproductive health programs that expand opportunities for women, men, and young people in developing countries. Pathfinder provides a range of services from contraception and maternal care to HIV prevention and AIDS care and treatment through innovative approaches and community participation. Learn more at

About UCSF

The UCSF Safe Motherhood Program at the Bixby Center for Global Reproductive Health is a research group that works to prevent maternal death and promote women’s health and human rights by conducting rigorous research and creating practical links from research to policy and implementation.