Professor Suellen Miller is Director of the Safe Motherhood Program and Professor, UCSF Dept. of Obstetrics and Gynecology. Professor Miller has been practicing as a certified nurse-midwife since l977, and is the author of the Hesperian Foundations’ “A Book for Midwives”. She conducts both qualitative and quantitative research, mainly in lower resourced settings, primarily focused on maternal survival and maternal health. Her studies include contraceptive research in Africa and Asia, misoprostol clinical trials in Tibet and India, the clinical trials of the Non-pneumatic Anti-Shock Garment (NASG), and the continuum of maternal care in Peru, Dominican Republic, Bangladesh, Nigeria, Egypt, Ethiopia, Zambia, Zimbabwe, Timor Leste, and Tanzania, among other reproductive and sexual health projects and programs.. The author of over 100 peer-reviewed journal articles, Professor Miller is co-author of “Beyond Too Little Too Late, Too Much Too Soon,” in the Lancet 2016 Maternal Health Series.
Despite some advances in individual technologies and strategies, hemorrhage remains one of the major killers of pregnant, childbearing, and postpartum women, especially in lower resourced settings. Maternal mortalities and morbidities have actually risen in many of these places, including in some higher resourced settings, such as the US. In this presentation we will review some of the newer innovations in hemorrhage prevention, recognition, and management, such as the improvised, low cost uterine balloon tamponade, non-pneumatic anti-shock garment, use of standardized blood mats, community distribution of oral/sublingual misoprostol, a uterine balloon that releases Tranexamic Acid, drones for blood delivery in remote areas, and more. We will discuss the influence on Ministries of Health and program managers of the World Health Organization’s recommendations on technologies for PPH. We will then describe and discuss why PPH bundles may be a more efficient way to package and train on technologies and strategies.
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