Our goal is to prevent maternal deaths by promoting women's health and human rights. The opinions expressed on this page are those of the Safe Motherhood Program, and do not necessarily reflect those of the University of California San Francisco.
Results of the World Health Organization consultation on postpartum hemorrhage care bundles are now available in the International Journal of Gynecology & Obstetrics, with great gratitude to our coauthors in advancing the use of the NASG and other lifesaving recommendations... Suellen Miller Michelle Skaer Therrien
obgyn.onlinelibrary.wiley.com Objective To systematically develop evidence‐based bundles for care of postpartum hemorrhage (PPH). Methods An international technical consultation was conducted in 2017 to develop draft bundles o...
Suellen Miller launching the postpartum hemorrhage care bundle MOTIVE multi-country study with the team from University of Birmingham and WHO.
Thrilled to see Investigators developing protocols for "Understanding Effectiveness of Implementation of a Postpartum Hemorrhage Initial Response Bundle" in India, Kenya, Nigeria, South Africa and Tanzania with guidance from WHO and support from the Bill & Melinda Gates Foundation.
On Oct 23, the Lancet Maternal Health series will launch a free online course featuring Professor Suellen Miller and UCSF’s Kathryn Millar, RN, MPH. Register now to participate in their session on Quality of Maternal Health Care.
maternalhealthseries.org Building on and extending the reach of The Lancet Maternal Health Series, a new Massive Open Online Course (MOOC) starting 23 October 2017 will bring the wealth of learning in the Series to the next generation of maternal health researchers globally. The course, The Lancet Maternal Health Series: Gl...
The World Health Organization has revised its comprehensive publication, "Managing complications in pregnancy and childbirth: a guide for midwives and doctors." This new edition of the manual has updated recommendations to coincide with current WHO recommendations and includes the Nonpneumatic Anti-shock Garment (see pages 5-6 of the briefing paper for changes to Management of PPH). Click the link for the full publication or the briefing paper which summarizes the key changes made in the second edition.
who.int This manual is written for midwives and doctors at the district hospital who are responsible for the care of women with complications of pregnancy, childbirth or the immediate postpartum period, including immediate problems of the newborn.
bixbycenter.ucsf.edu Bixby researchers have previously proven that a simple, low-tech device, known as a non-pneumatic anti-shock garment (NASG), can prevent maternal deaths due to severe postpartum bleeding. A new study tested the garment’s effectiveness in a critical care setting in Colombia.
The NASG has been identified as one of the innovative technologies for use in low-income settings in a compendium released by the World Health Organization. Access the full compendium online here:
who.int One of the cornerstones of the Universal Health Coverage (UHC) initiative is access to essential medicines and health technologies. Medical devices, assistive devices and eHealth solutions are important components of health technology, which have the potential to save lives and improve quality of li...
The Indian Express covered Professor Suellen Miller’s NASG training which marked the launch of the pilot project in Palghar conducted by the Indian government’s Department of Health Research on January 30th. The project will introduce non-pneumatic antishock garments in 46 health centers and sub-centers.
indianexpress.com Invented by NASA for astronauts, anti-shock material can help prevent excessive bleeding.
Our article "Beyond Too Little, Too Late and Too Much, Too Soon: A Pathway Towards Evidence-Based, Respectful Maternity Care Worldwide" was named one of the best articles on Women's Global Health for 2016 by Obstetrics & Gynecology (The Green Journal)
journals.lww.com This month we focus on current research in global women's health in obstetrics and gynecology. Drs. Autry and Petersen discuss six recent publications, which are concluded with a “bottom line” that is the take-home message. The complete reference for each can be found in Box 1 on this page, along...
We are delighted to see the Lancet Maternal Health Series, 2016 named the #1 of the Maternal Health Task Force's Top 10 events in Maternal Health.
#1: The Lancet Series on Maternal Health
In September 2016, the MHTF supported the launch of The Lancet Maternal Health Series, a collection of six papers highlighting the importance of improving access to high quality maternal health care for all women across the globe. The papers call for increased efforts to prioritize quality maternal health services, promote equity through universal coverage, strengthen health systems, guarantee sustainable financing and accelerate progress through evidence, advocacy and accountability.
Following the series launch, the MHTF co-hosted an event at the Wilson Center in Washington, D.C. titled “What Next? Putting The Lancet Maternal Health Series Into Action” as a part of the Advancing Dialogue on Maternal Health Series. The goal of this discussion was to explore strategies for translating findings from The Lancet Maternal Health Series into global maternal newborn health improvements.
Read more via the link below, and read the full text of the paper here:
mhtf.org 2016 was an exciting year for the global maternal health community. In reflecting back on this past year, the Maternal Health Task Force compiled a list of our top 10 highlights.
A new article discusses the recent Lancet paper by Professor Suellen Miller, highlighting inequitable care and the dangers of too much too soon and too little too late in maternity care.
passblue.com TOPIC: WOMENIn Reducing Maternal Deaths, Too Much Care Can Be as Damaging as Too Little by Lori Silberman Brauner • October 31, 2016 • Gender-Based Violence, Health and Population, Women • Facebook Twitter Email SubscribeSubscribe to PassBlueSubscribe to our mailing list and get interesting stuff a...
The Hindu reports that the government of Tamil Nadu State, India is introducing Life Wrap NASGs to all public hospitals, primary care facilities, and 108 ambulances:
thehindu.com A demonstration on the use of anti-shock garment for use by pregnant women was conducted at a function held at the Dr. Muthulakshmi Reddy Memorial Government Headquarters Hospital here on Thursday.D.
An independent assessment of nurse midwives' knowledge of LifeWraps in Nigeria by Onasoga et al in the International Journal of Reproduction, Contraception and Gynecology suggests that NASG should be made widely available and should be part of PPH management protocols.
ijrcog.org Midwives’ knowledge and utilization of non-pneumatic anti shock garment in reducing complication of postpartum haemorrhage in selected health care facilities in Bayelsa state Nigeria
New research from the Safe Motherhood Program demonstrates that the NASG significantly reduces blood loss in women who experience post-abortion hemorrhage and results in a clinically important 52% lower odds of mortality. This study was conducted with partners at Los Angeles Medical Center and UC Berkeley. Read the full article:
safemotherhood.ucsf.edu Published Sept 2015
UCSF’s Safe Motherhood Program and colleagues have tested a novel approach to manage postpartum hemorrhage: ‘secondary prevention/early treatment’ using misoprostol to treat only women with above average bleeding. This study demonstrates secondary prevention/early treatment to be a feasible non-inferior alternative strategy to universally medicating all women who deliver. Read the full article here:
onlinelibrary.wiley.com Raghavan S, Geller S, Miller S, Goudar SS, Anger H, Yadavannavar MC, Dabash R, Bidri SR, Gudadinni MR, Udgiri R, Koch AR, Bellad MB, Winikoff B. Misoprostol for primary versus secondary prevention of postpartum haemorrhage: a cluster-randomised non-inferiority community trial BJOG 2015; DOI: 10.1111…
New research on measuring the quality of intrapartum and immediate postpartum care calls Professor Suellen Miller’s work on high mortality in poor quality EmONC settings groundbreaking.
Read the article by Tripathi et al:
and read the original article by Professor Miller:
"The true cost of maternal death: individual tragedy impacts family, community and nations"
A commentary by Professor Suellen Miller and Dr. José M Belizán has been published in Reproductive Health. Read the article here:
UCSF Safe Motherhood donates LifeWraps for use in Nepal as part of the post-earthquake intervention to keep women. Watch the video to see more about safe births in Nepal.
Join our community of caring as we raise money to provide essential supplies, shelter & care so that all MotherBaby's in Nepal survive and thrive. Attend or ...
UCSF Global Health Sciences interviews Professor Suellen Miller about the new agreement to reduce the cost of the Non-pneumatic Anti-Shock Garment and next steps for the future.
globalhealthsciences.ucsf.edu An agreement announced April 2015 will reduce the achievable cost per use of the Non-pneumatic Anti-Shock Garment (NASG) by over 75 percent and expand access to this innovative new product, which has been shown to safely and effectively reduce mortality due to post-partum hemorrhage, a leading cause…
A joint partnership announced today between the UN Commission on Life-Saving Commodities for Women and Children, the Clinton Health Access Initiative, Inc., the Safe Motherhood Program at the University of California, San Francisco (UCSF), and the Blue Fuzion Group will reduce the cost of the Non-pneumatic anti-shock garment (NASG/Lifewrap) and expand access to this life-saving innovation, which reduces maternal mortality from hemorrhage.
Read the full press release here: http://www.safemotherhood.ucsf.edu/wp-content/uploads/2015/04/NASG-Press-Release-8Apr2015.pdf
CMQCC announces new PPH Toolkit (www.cmqcc.org), that includes NASG as a technology. Originally produced in 2010, the Toolkit has been completely revised. Professor Miller has served on the Hemorrhage Toolkit Task Force since its inception.
cmqcc.org CMQCC is devoted to eliminating preventable maternal death and injury and promoting equitable maternity care in California by bringing resources, tools, measures, and quality improvement techniques to providers, administrators, and public health leaders. This is a long term collaborative effort of…
A new device for early detection of shock: Researchers from Guy’s and St. Thomas’ and King’s College London have developed the Microlife Vital Signs Alert (VSA), a handheld device that measures blood pressure and pulse to calculate the risk of shock. Professor Suellen Miller of the Safe Motherhood Program advised the team during development.
kcl.ac.uk The world's first medical device to detect shock and high blood pressure in pregnant women could cut maternal deaths in developing countries by up to 25 per cent. Researchers from Guy's and St Thomas' and King's College London have developed the Microlife Vital Signs Alert (VSA) with a $1 million gr…
A New article in the British Journal of Obstetrics and Gynecology (BJOG) by UCSF Safe Motherhood Program and King's College London finds Shock Index is a Superior Predictor of Adverse Outcomes in PPH.
Read the full article "Shock index: an effective predictor of outcome in postpartum hemorrhage?":http://www.safemotherhood.ucsf.edu/wp-content/uploads/2013/01/Shock-index-an-effective-predictor-of-outcome-in-postpartum-haemorrhage-.pdf
The NASG was highlighted as "rescue treatment" in the latest review article on postpartum hemorrhage (PPH) by Andrew Weeks, published in the January 2015 by BJOG.
This review acts as a comprehensive clinical guide to prevention, treatment, and rescue care of postpartum hemorrhage with the latest evidence available.
Professor Weeks notes the NASG’s promise for use in low-resource settings, due to its ease of application and cost effectiveness, and emphasizes its efficacy in reducing extreme adverse outcomes and maternal mortality as demonstrated in a major cluster randomized controlled trial.
Read the full article here:http://www.safemotherhood.ucsf.edu/wp-content/uploads/2013/01/The-prevention-and-treatment-of-postpartum-haemorrhage-what-do-we-know-and-where-do-we-go-next.pdf
NASG – A Success in Cambodia
At a December 2014 National EmONC workshop in Cambodia, the NASG was a hot topic. The NASG had been introduced in Cambodia by Jerker Liljestrand of URC Better Health Services in 2012. Demand is now increasing for nation-wide implementation. Users say that having the NASG is empowering for the health center midwives; they now know there is something they can do to save a mother's life.
There is also an interesting "red flag effect" where the red NASG acts as a red flag. Once it has been applied at the health center, everyone knows that you must send the woman to a referral hospital at once, and at the referral hospital any woman who arrives wearing the NASG is “wearing” a red flag requiring urgent care.
First Woman's Life Saved by LifeWrap in Tanzania
In November 2014, we arrived in Tanzania to launch the Ifakara Health Institute’s (IHI) Maternal Health intervention. The LifeWrap and mobile phones will be distributed across 8 rural districts and 278 health facilities.
For the first level of training all Referral Facility staff were trained to use the LifeWrap. The trainers included Suellen Miller and Michelle Skaer from UCSF’s Safe Motherhood Program, Rhoda Amafumba (consultant midwife from Zambia), and IHI staff, Seleman Mbuyuti, Robert Tilya, Iddajovana Kinyonge, Godfrey Mburuka, Ritha Godfrey, and Zac Mtema.
The first woman was saved by the LifeWrap just days after the introduction.
As the Ifakara training team was still on the road, heading home from training and equipping the sites, they received a phone call from a newly trained hospital. Seleman Mbuyita, the team leader reported:
“A woman’s life has been saved. Kahama hospital received a referral case of a woman from the health center with placenta previa who had turned paper white but LifeWrap came to rescue! The woman rests in post op ward in a sound condition. What can be more rewarding than this. I was feeling very exhausted but suddenly I am rejuvenated!”
FIGO Guidelines Recommend LifeWrap to Treat Hypovolemic Shock Secondary to Obstetric Hemorrhage
Mother Baby Friendly Birthing Facility Guidelines Created to End Abuse in Birthing Care World Wide!
These guidelines provide criteria promoting the women’s agency in their birthing experiences, nondiscrimination, access to affordable or free evidence-based maternity care, pain relief practices, immediate skin-to-skin mother-baby care and breastfeeding, and the elimination of all verbal, emotional, physical, and financial abuse, practices that all too often accompany birthing care.
Read more below:
Listen to our LifeWrap Igniter Dr. Suellen Miller discuss the LifeWrap's start and its profound global effects in saving mothers' lives despite pervasive social and gender inequities.
An interview with with Barbara Glickstein from Healthstyles, Center for Health Media and Policy at Hunter College,
centerforhealthmediapolicy.com Healthstyles on Thursday, December 18th is hosted by Barbara Glickstein and features interviews with two global nurse leaders innovating with new technologies that are having an impact in managing ...
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