Managing postpartum hemorrhage depends in part on having a prepared mind, a complement of trained coworkers, and full access to modern therapies. The last 2 components are rare in resource-poor areas and their absence may be accentuated by climatic instability and lack of basic transportation. Greater use of the active management of third stage of labor and administration of misoprostol by nontrained birth attendants will provide beneficial reductions in hemorrhage rates in resource-poor areas. Additional improvements depend on increasing public awareness, facilitating existing nongovernmental organizations in their community-related, upgrading training of traditional birth attendants, and providing cell phone communication to workers in remote areas, in addition to providing better access to blood.
*Department of Obstetrics and Gynecology, Kingston Hospital, Galsworthy Road, Kingston Upon Thames, Surrey, United Kingdom
†Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Correspondence: Louis Keith, MD, PhD, ScD (Hon), Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL. E-mail: firstname.lastname@example.org
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