A comparison of excessive postpartum blood loss estimates among three subgroups of women attending births in Matlab, Bangladesh.
OBJECTIVE
Postpartum hemorrhage (PPH) is the leading cause of maternal death and disability worldwide. Recognition depends on subjective visual quantification. This study sought to assess and compare the thresholds for excessive postpartum blood loss reported by skilled birth attendants (SBA), traditional birth attendants (TBA), and laywomen in Matlab, Bangladesh.


METHODS
Data from six questions asking about excessive blood loss in the postpartum period were analyzed using analysis of variance (ANOVA), Hochberg test, Kruskal-Wallis and standard descriptive statistics.


RESULTS
Thresholds for excessive blood loss estimated by laywomen and TBAs exceed biomedical standards for PPH. Skilled birth attendant reports are consistent with the definition of severe acute PPH.


CONCLUSIONS
Further research on locally validated blood collection devices, in birth kits, for diagnostic aid or referral indication is needed. Areas where coverage and uptake of skilled birth attendance are low should be targeted due to the number of home births attended by TBAs and laywomen in such settings.


CONCLUSIONS
A comparison of excessive postpartum blood loss estimates among skilled birth attendants, traditional birth attendants and laywomen in Matlab, Bangladesh.
Edmonds
Joyce K
JK
Center for Research on Maternal and Newborn Survival, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
Hruschka
Daniel
D
Sibley
Lynn M
LM
D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D003153:Community Health Services / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006700:Home Childbirth / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D008428:Maternal Mortality; D008880:Midwifery / Q000379:methods / Q000706:statistics & numerical data*; D006473:Postpartum Hemorrhage / Q000453:epidemiology*; D011247:Pregnancy; D012424:Rural Population; D055815:Young Adult