When our research team first started exploring whether an off-patent drug called tranexamic acid could reduce the number of people—mainly young men—who bled to death as a result of trauma, I never imagined that more than a decade later I would be surrounded by maternal health experts discussing how this treatment could help new mothers around the world. But that’s exactly where I found myself at a special event at the London School of Hygiene & Tropical Medicine (LSHTM) titled, “How can we stop women bleeding to death in childbirth?”
Six months after results from the WOMAN trial were published, the World Health Organization (WHO) updated its guidelines to include the use of tranexamic acid for prevention of PPH. Our hopes for the WOMAN trial came to fruition, demonstrating the protective effect of tranexamic acid on postpartum hemorrhage (PPH), a devastating complication that kills roughly 100,000 women every year—or one woman approximately every six minutes. We found that tranexamic acid, when administered within three hours of delivery, reduced a woman’s risk of death due to bleeding by one-third.
All too often we scientists focus our energy on conducting high quality medical research and collecting more and more evidence to improve health outcomes—and this is important. However, research doesn’t have an impact on people’s health unless the information reaches clinicians and policymakers who can implement the findings. As Professor Joy Lawn, Director of the MARCH Centre at LSHTM and chair of the event highlighted, “Tonight is about time. Time that we take a stand to say that women shouldn’t be dying from something preventable, like bleeding.”
As I reflect on the discussions, I have thought about two keys that have helped the WOMAN trial results lead to better maternal health outcomes and more effective policies: collaboration and creative communication.
The WOMAN trial was a collaboration on an epic scale, involving 20,060 women from 193 hospitals in 21 countries and thousands of doctors, midwives and nurses. We were delighted to have representatives from some of these groups at the event, including Sir Sabaratnam Arulkumaran, former president of the Royal College of Obstetricians and Gynaecologists and the International Federation of Gynecology and Obstetrics, and Her Excellency Toyin Saraki, Founder-President of the Wellbeing Foundation Africa and ambassador for the International Confederation of Midwives.
In addition, recognizing the importance of including representation from professional bodies, maternal health advocacy groups and policymaking organizations, the WOMAN trial steering committee elicited feedback from WHO colleagues from the beginning.
Involving numerous stakeholders from different sectors throughout the process helped ensure that the findings would translate into maternal health policy change.
As researchers, we need to be creative about how we share findings to reach a target audience. Some strategies for effective communication include letters, fact sheets and presentations at conferences. Harnessing the power of social and digital media by translating research findings and information into a story is another opportunity. In the past, the WOMAN trial collaborators and I have produced cartoons and animations to illustrate how tranexamic acid works. We have found videos to be another effective vehicle to tell the stories of women who experienced severe blood loss during childbirth and how it impacted their lives.
At the event, we unveiled a new communication tool—the Blood Clock—which will remain on display at LSHTM until February 2018. The Blood Clock is a unique art installation whose aim is to raise awareness about PPH and the need for urgent treatment, illustrating that every six minutes, somewhere in the world, a woman dies from PPH. It was created by Consultant Obstetrician Dr. Graham Tydeman, who regularly deals with the problem of blood loss in childbirth.
Now we need to keep the momentum going. I call on providers, policymakers and other members of the global maternal health community to act on these findings and educate others about tranexamic acid. No woman should die from preventable causes on the day she gives birth.
Watch a video of the Blood Clock.
Read the findings from the WOMAN trial.