Prevention of postpartum hemorrhage at home birth in Afghanistan

Harshadkumar Sanghvi
Nasratullah Ansari
Ndola Prata
Hannah Gibson
Aftab T. Ehsan
Jeffrey M. Smith

Objective To test the safety, acceptability, feasibility, and effectiveness of community-based education and distribution of misoprostol for prevention of postpartum hemorrhage at home birth in Afghanistan. Methods A nonrandomized experimental control design in rural Afghanistan. Results A total of 3187 women participated: 2039 in the intervention group and 1148 in the control group. Of the 1421 women in the intervention group who took misoprostol, 100% correctly took it after birth, including 20 women with twin pregnancies. Adverse effect rates were unexpectedly lower in the...