Lynn Sibley, CNM, PhD, is Associate Clinical Professor and Academic Director of the Lillian Carter Center for International Nursing. She holds a joint appointment in the Rollins School of Public Health, Department of Global Health, and an adjunct appointment in the Department of Anthropology, Emory University, Atlanta, GA.
Recognition of and Response to Postpartum Hemorrhage in Rural Northern India
Article first published online: 24 DEC 2010
2005 American College of Nurse Midwives
Journal of Midwifery & Womens Health
Volume 50, Issue 4, pages 301–308, July-August 2005
How to Cite
Sibley, L., Caleb-Varkey, L., Upadhyay, J., Prasad, R., Saroha, E., Bhatla, N. and Paul, V. K. (2005), Recognition of and Response to Postpartum Hemorrhage in Rural Northern India. Journal of Midwifery & Womens Health, 50: 301–308. doi: 10.1016/j.jmwh.2005.03.006
- Issue published online: 24 DEC 2010
- Article first published online: 24 DEC 2010
- postpartum hemorrhage;
- maternal mortality;
- safe motherhood;
- birth preparedness;
- health seeking behavior
This study describes the results of a Morbidity and Performance Assessment (MAP) conducted to provide insight into the medical factors contributing to maternal and newborn morbidity and mortality in a rural district of northern India, and to use these insights to develop a locally appropriate, community-based safe motherhood program The MAP study was based on verbal autopsy method. Five hundred ninety-nine women (or in the case of 9 maternal deaths, a family member) participated in the study. This article describes a subsample of women who reported signs or symptoms suggesting excessive bleeding (n = 159). Findings include a poor knowledge of danger signs; poor problem recognition during labor, birth, and the immediate postpartum period; and a low level of health seeking that was consistent with poor recognition. Maternal sociodemographic characteristics, antenatal care use, and knowledge of danger signs were generally not associated with problem recognition and health seeking. The case fatality rate was 4%. These findings suggest an urgent need to understand the phenomenon of problem recognition and to integrate this into the design of interventions to reduce delays in health seeking.