From 4-6 May, the Asia Regional Meeting on Interventions for Impact in Essential Obstetric and Newborn Care is being held in Dhaka, Bangladesh, with an opening ceremony and optional supplementary sessions on 3 May 2012. Organized by the Government of Bangladesh, MCHIP, and the Bill & Melinda Gates Foundation-supported Oxytocin Initiative, in collaboration with Women Deliver, VSI, FIGO, and ICM, this three-day meeting will focus on postpartum hemorrhage (PPH), pre-eclampsia/ eclampsia (PE/E) and other aspects of maternal and newborn health.
For more information on the conference, click here. A live webcast begins May 4th, and related resources -- included presentations -- can be found here. Please also connect with the conference via Facebook and Twitter!
Below is the first of a series of blogs from conference attendees. Please find other blogs in the series by:
Ms. Alice Levisay on expectations of the conference,
Rae Galloway and Dr. Justine Kavle on introducing and implementing calcium supplementation to prevent pre-eclampsia,
Ms. Pashtoon Azfar on the role and importance of midwives, and
Dr. Jeffrey Smith on a decade of maternal health successes and the challenges ahead.
Though I have been in this field for over 20 years, I first became interested in women’s health and family planning when I prepared a presentation about contraceptive methods during medical school in the early 1990s. When I found out that simple information and contraceptive methods were not available to many women, it triggered a very strong response in me, it felt very unfair. I thought, if women are carrying the largest burden of reproduction due to their biology, they should have the means to do it well for the benefit of their families and society.
One of the ways that I believe we can help women and their communities is through the acceptance and use of misoprostol. Misoprostol is a type of uteronic drug that helps to induce labor and prevent postpartum hemorrhage (PPH), which is a leading cause of maternal death. In Asia, the evidence is clear that women have been very responsive to the provision of misoprostol for PPH prevention at the community level. Women have understood how to use misoprostol correctly and it was the success of women, community health workers, traditional birth attendants, and everybody else who was
present at the time of birth that gave us these good results.
I think the greatest barriers to the use of misoprostol are the assumptions about what women might do, and not trusting them. For instance, we had assumptions about how they would behave when they were given misoprostol in advance for PPH—would they run back to their homes and never come to the facility again? Or will they misuse it for other indications? An added barrier arises when funders and policymakers hold these assumptions.
I believe we should focus on what works to prevent maternal deaths and the best ways to ensure that PPH management programs are safe and effective for women and their communities. We must ask women what they need and trust that they will choose the best thing for themselves and for their babies. And to ensure the quality and potential impact of misoprostol use, we need to continue monitoring and evaluating our programs, and give clear guidance on how the drug works and should be used. We must also scale up community level use of misoprostol until it is a routine part of care for all pregnant women, particularly at home deliveries.
What I have realized in the course of my work is the importance of community and cultural, which sometimes contrast sharply in opinion with the medical establishment. I think misoprostol is a very good example of how these two spheres—community and medicine—can be combined to reach the same goal: saving women from dying during childbirth. If we all agree that improving a woman's health is one of the best ways to empower her, we must make the mutual commitment to do whatever we can to
improve the conditions for women.
Dr. Nuriye Hodoglugil
Venture Strategies Innovations