As I have written many times before postpartum hemorrhage (PPH) or excessive uterine bleeding after childbirth is the leading cause of maternal mortality in low-and-middle income countries. The recommended drug to prevent PPH according to the World Health Organization (WHO) is oxytocin. When administered in its recommended dose it causes little to no side effects. Oxytocin, the WHO’s current gold standard therapy, however, must be refrigerated and administered by skilled health workers posing two obstacles to its wider use in low resource, tropical settings.
Some countries have approved misoprostol, an oral drug, to prevent PPH, but there are several concerns that its use can be misappropriated for abortions instead of used solely for PPH. The World Health Organization has listed misoprostol as an alternative to oxytocin if it is not available.
Now, another PPH preventative drug, carbetocin, has been added to the latest updated 2019 WHO Essential Medicines List. The announcement was made last week. Unlike oxytocin, even at high temperatures carbetocin remains effective. The recommendation is that carbetocin can be used when oxytocin is not available or if its quality is uncertain. Additionally, the cost must be comparable to oxytocin.
When people think about new inventions, 95% of them immediately begin thinking about tech inventions, but what about medical inventions that save lives?
Merck recently launched a video that asked Americans what invention they are waiting for. Take a look.
Did you know 68% of Americans cannot name a single scientist working to invent medicine?
Merck has been working for over a century on medicines and vaccines that save lives. Visit their site on Inventing for Life where you can see a timeline of Merck’s work as well as meet some of its scientists, and see some of its impact on the world’s most challenging diseases.
I’m happy to share this video today as I know how important their work is on maternal health with Merck for Mothers.
When everyday Americans think about women dying during childbirth it is probable that their initial thoughts travel directly to Africa where it is quite well known that maternal mortality is rife. Chances are their thoughts never focus on the deaths and near deaths during childbirth that women experience right here in the United States. After all, the overwhelming consensus is that the United States has the best medical care, superior health workers and health system in the world despite some of its inherent challenges. This thinking renders maternal mortality in the US thoroughly inconceivable to many even while data reveal it should not be inconceivable at all. In fact, maternal mortality is on the rise in America having doubled over the past 25 years all while global maternal deaths are steadily declining. Globally, maternal mortality was effectively reduced by 44 percent according to the World Health Organization.
The United States, while not the overall leader in maternal mortality among all countries, it is the leader among all developed nations. The United States ranked number 33 out of 179 countries in Save the Children’s 2015 Mothers’ Index Ranking and 46th in the world due to the rate of women who die from pregnancy and childbirth complications. Compared to other developed countries, the United States’ ranking is abysmal, especially with Norway, Finland, and Iceland ranking in the top three overall. Even countries like Estonia and Belarus, whose GDPs are considerably lower than ours, far outrank America.
Earlier this year I wrote about the important maternal mortality art work of Chicago-based artist and activist, Michelle Hartney and her plan to sew 1,200 hospital gowns for her performance art, MOTHER’S RIGHT — one for every woman who died in the US during childbirth in 2013.
Hartney will perform this piece on September 7th at the Daley Center in Chicago at Improving Birth’s “Liberate Labor” rally.
Today she announced on Instagram that the 1200 gowns have been completed. The photo stuck out to me not only because the gowns are finished, but because 1200 women died during childbirth in America two years ago, the highest number of any developed nation.
While there is a national push to reduce maternal mortality numbers in the US, those numbers are still moving in the wrong direction as Dr. Priya Agrawal, Executive Director of Merck for Mothers, recently said in our interview in our Maternal Health Heroes series.
Throughout the summer we will speak with some of the most notable maternal health advocates in the world ahead of the Global Maternal Newborn Health Conference that will be held in Mexico City between October 18 – 21, 2015. Follow the conversation at #MHHSS. Read all of the interviews below.