How a neoprene body wrap is saving new mums’ lives
It looks like a makeshift wetsuit, but it’s not for surfers. The so-called non-pneumatic anti-shock garment (NASG) uses the power of compression to stop women from bleeding to death in childbirth. It’s really that simple.
The NASG was originally developed by a team at the National Aeronautics and Space Administration in the US, but it never really took off there. The inexpensive device is a low-tech, washable and reusable body wrap weighing about 1.5kg that’s made of segmented pieces of neoprene, which is fastened with Velcro™ over a foam compression ball. Once in place, it applies enough counter pressure around the body to decrease blood loss and reverse shock resulting from pregnancy- or childbirth-related haemorrhage by increasing blood pressure to the heart, brain and lungs.
Back in 2002, Suellen Miller, director of the Safe Motherhood Program and a professor at the University of California, San Francisco, recognised the potential of this first-aid device to reduce deaths among new mothers in developing countries. “When I heard about the NASG I thought perhaps we could adapt it for use in low-resource settings and save women who were dying waiting for care,” said Dr Miller, who had delivered thousands of babies as a nurse-midwife before changing her career to focus on maternal health in these countries.
“Haemorrhage is the number one killer of pregnant/birthing women,” she told This Is Medtech. “Women die because they start to bleed at home, or in underequipped, understaffed facilities. They may bleed to death in as little as two hours, but it may take six, eight or even up to 48 hours before a bleeding woman in a low-resource setting reaches a facility that can provide her the attention she needs,” she explained.
The NASG can stabilise patients for up to three days, until they can be transported to a health centre with the ability to administer blood transfusions and provide definitive medical or surgical interventions.
A long road…
It took Dr Miller’s international team over ten years to test the NASG on patients, in addition to doing advocacy work to get it onto the World Health Organization and International Federation of Obstetricians and Gynecologists’ Recommended Lists, but her perseverance is now bearing fruit. The NASG has been used on over 10,000 women in 33 countries, and studies confirm that the device reduces maternal mortality (deaths from pregnancy and childbirth related complications) by 50-60%.
“That is a huge effect, and a rare one with such a simple device for something as intractable as maternal mortality,” noted Dr Miller. “Getting the statistical evidence was necessary but equally rewarding is to see the effect on individual women, their families, and care providers. When a woman goes unconscious and is bleeding heavily it is amazing to simply wrap her lower body tightly in the NASG, and watch as she ‘returns’ from unconsciousness, opens her eyes and looks around. The family is weeping tears of joy, the nurses and doctors are beaming. It’s amazing,” she said.
More work to be done
According to the Safe Motherhood Program, a woman somewhere in the world dies from obstetric haemorrhage every four minutes.
Dr Miller’s goal is therefore to get the NASG in “every village, every ambulance, and every primary health care centre….so there is still a lot of advocacy to be done to be sure that everyone who needs it has access to this device,” she added.
Another challenge is making sure health care workers are trained to use the device so that it can be incorporated into their routines. “Also, with the world in crisis, we need to get more NASGs into humanitarian settings ‒ women in migration do not stop having babies or needing safe motherhood,” Dr Miller pointed out.