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 Background to the study
 Postpartum haemorrhage (PPH) is an obstetric emergency that may follow vaginal or caesarean birth. The World Health Organization (WHO, 2014) defined PPH as the loss of more than 500mls of blood after vaginal delivery. PPH could occur within few hours of delivery of the baby or within 6 weeks postpartum, with uterine atony being the major cause (Healthline, 2012). Postpartum haemorrhage has a global prevalence rate of 6% and 10.5% in Africa with associated case fatality of 1% and estimated to contribute about 25% of global maternal death (Clinical Practice Guideline, 2010). According to Fawole, Awolude, Adeniji & Onafowokan (2010), PPH accounts for more than 30% of all maternal deaths and this varies considerably between developed and developing countries. It is the leading cause of maternal mortality and morbidity with highest prevalence in developing countries (Allan, 2010).This implies that Africa as a continent is lagging behind in containing maternal mortality due to postpartum haemorrhage. Maternal mortality is defined by WHO (2014) as the death of a woman while pregnant or within 42days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from incidental or accidental causes. The maternal mortality ratio (MMR) is the number of maternal deaths during a given period per 100,000 live births during the same time period (WHO, 2014). The International Confederation of Midwives (ICM) stated that “every minute around the world, 380 women become pregnant, 110 women experience pregnancy related complications, and 1 woman dies”. This implies that 529,000 women die annually from pregnancy complication or childbirth. This is quite alarming! Ajefunja, Adepiti & Ogunniyi (2010), stated that an overwhelming proportion of about half a million women who die as a result of complications of pregnancy and childbirth, occur in developing countries where facilities are either poorly developed, or there is lack of trained attendants at delivery. Majority of these deaths occur within 24hours of delivery and in most cases are due to PPH (Ajefunja et al., 2010). According to the United Nations Population Fund Agency (UNFPA) reports in 2010, developing nations accounted for ninety-nine percent (99%) of maternal deaths with majority of these deaths occurring in sub-Saharan Africa and Southern Asia. Nigeria was rated second highest contributor with 14% or 40,000 deaths while India was first with 19% or 56,000 deaths. The burden of postpartum haemorrhage on developing countries cannot be overemphasized. Many women have lost their lives, some have lost their uterus and many who survived it, are faced with one health challenge or the other. Many children have also been rendered motherless and many families suffer pain. It is not out of place to say that PPH is also a social menace because marriages have been broken in some cases of uterine loss, children have been neglected or abandoned in some cases of maternal deaths and often, there is society-directed violence when many families suffer pain. Fathalla as reported in Obinna (2014) stated that women are not dying because of the disease that cannot be treated, but are dying because the society is yet to make the decision that their lives are worth saving. This implies that PPH as the highest contributor to maternal deaths could be prevented to make childbirth safer. The intervention to prevent PPH in developing countries is no doubt pivotal in the global effort to achieve the millennium development goal (MDG5) of reducing maternal mortality ratio by three quarters by 2015 from 1990. Also foremost among the objectives of the nation’s policy on reproductive health is, to reduce maternal morbidity due to pregnancy and childbirth by 50%. The International Federation of Obstetricians and Gynaecologists (FIGO) and the International Confederation of Midwives (ICM) in collaboration with WHO, have recommended active management of the third stage of labour (AMTSL) and routine use of uterotonics for prevention of PPH (PATHS, 2014). However the low socio-cultural and economic status of women as well as the inadequacies of our existing health systems, have contributed to the delays that lead to complications and the death of women with PPH (WHO, 2014). Nigeria as one of the developing countries was ranked the second highest contributor to global maternal death and Ebonyi being one of the states with high maternal mortality rate of 800 per 100,000 (Ebonyi State Ministry of Health, 2010), is deemed as suffering severely the impact of this menace. Being a gender based health problem, PPH like many other health conditions require critical attention to curb its menace on the health of the nation, and precisely that of women. From the foregoing, it is therefore expedient to investigate the prevalence and outcome of postpartum haemorrhage in Federal Teaching Hospital Abakaliki to provide a baseline data in nursing literature in this area of study in Ebonyi State.

Project detailsContents
Number of Pages112 pages
Chapter one Introduction
Chapter two Literature review
Chapter three  methodology
Chapter  four  Data analysis
Chapter  five Summary,discussion & recommendations
Chapter summary1 to 5 chapters
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