Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #104571

Suellen Miller, CNM, PhD¹, Oladosu Ojengbede, MD², Erin Bray³, Felicia Lester, MD, MPH⁴, AO Fabamwo⁵, Mohason Bello², OI Akinola⁵, Karla Berdichevsky, MD, MPH⁶, Inova Campos, MD, MPH⁷, Jennifer Lynn Catino, MPH⁸, Alberto Martinez, MD⁶, Juan Carlos Ledezma, MD, MPH⁷, Monique Webster⁹, and Paul Hensleigh, MD¹⁰. (1) Department of ObGyn & RS: WGHI Safe Motherhood Programs, University of California, San Francisco, 74 New Montgomery, Suite 600, San Francisco, CA 94105, 415 597 9394, suellenmiller@hotmail.com, (2) Department of Obstetrics and Gynecology, University College Hospital, ., Ibadan, 070, Nigeria, (3) MPH Program, University of California, Berkeley, 160 Central Avenue, Apt #3, San Francisco, CA 94117, (4) Joint Medical Program, UC Berkeley/UCSF, 2528 Le Conte, Berkeley, CA 94809, (5) Department of Obstetrics and Gynecology, Lagos University Teaching Hospital, ., Lagos, Nigeria, (6) The Population Council, Panzacola 62 Int. 102, Villa Coyoacan, Mexico City, 04000, Mexico, (7) IMSS/Opportunidades, Calle Toledo 39, Col. Juarez, Mexico City, 04000, Mexico, (8) Regional Office for Latin America and the Caribbean, Population Council, Panzacola No. 62, Interior 1, Colonia Villa Coyoacan, Mexico City, 04000, Mexico, (9) MPH Program, University of California, Berkeley, 500 Masonic #9, San Francisco, CA 94117, (10) Stanford University, 810 Allardice Way, Stanford, CA 94305

Background: Maternal mortality from obstetric hemorrhage remains a problem in the developing world. In order to keep women alive during long transports to CEOC facilities and during long waits for blood, community-based first aid is needed. The non-inflatable anti shock garment (NASG) is a promising technology for providing resuscitation and reversal of shock and maintaining vital signs while decreasing blood loss.

Methods: As part of multi-site pre/post trial, women with obstetric hemorrhage and hypovolemic shock who were resuscitated with the NASG were interviewed. Also interviewed were facility-based and village-based health care providers as well as family members.

Results: A variety of perspectives on the use of the NASG are provided from near-miss maternal mortalities. Particularly relevant are reports by providers at all levels to a lifting of despair because they now felt there was something that could be done to save a woman's life. Family members who, in the middle of grieving for a woman they thought was dead, watch in wonder as the woman is resuscitated. The Nigerians nicknamed the resuscitated women, AYORUNBO, “she who has been to heaven and returned.” Once the word returned to villages that women survived, more families were willing to send women with hemorrhage to the hospital.

Conclusions: The NASG study is in process, however, the reactions of those who witness the use of the garment teach important lessons about acceptability and the importance of word of mouth in community outreach about new technologies.

Learning Objectives: