Safe birth with Misoprostol

If a woman gives birth in a hospital, medicines are available to treat PPH.

In a home birth, it is possible to prevent PPH in 60% of the cases if Misoprostol is used after the child has been born but before the placenta is out. Misoprostol causes contractions of the womb.

A home birth kit should contain: sterile scalpel (or shaving knife), 2 very clean threads, and three tablets of misoprostol.

A woman can use Misoprostol by herself or have anybody present at the birth help her, by following these 4 steps:

• Immediately after giving birth, dry the baby and put it on the belly of the mother or close to her breasts if she wants to breastfeed (HIV positive women should not breastfeed as it increases the risk of infection for the baby). Cover the head of the baby with a warm cloth or blanket

• Within 1 minute after the baby is born:

1. Feel the belly to make sure there is not another baby in the womb (twins). It is dangerous to use misoprostol if there is another baby because it can cause a rupture of the womb!!

2. Put 3 Misoprostol tablets of 200 mcg under the women’s tongue. She should let the tablets dissolve for 30 minutes before swallowing them. The womb will contract. The woman may experience fever/chills, nausea and vomiting, diarrhea, or cramps.

3. Clamp the cord (with the clean threads) and cut umbilical cord with sterile scalpel and wait for the placenta to come out.

4. Massage the womb (at the top end) after the placenta comes out until it is contracted (feels like hard ball). Do this every 15 minutes for the next 2 hours.

If the woman starts bleeding heavily, she can use an extra 4 tablets of misoprostol under the tongue to try stop the bleeding (treatment for PPH).

Always transport the woman to a hospital as soon as possible if:

• the placenta is not expelled within 30 minutes.
• a woman starts or continues to loose a lot of blood after using Misoprostol.