Published: 2017-07-26

A case of post-partum hemorrhage and sterilization in the developing world

Mark Hughes Crouch


A woman delivers a term infant vaginally at a district hospital in Papua New Guinea complicated by a retained placenta, uterine inversion and post-partum hemorrhage. A tubal ligation to protect the life of the mother from possibly fatal complications in future pregnancy is suggested, but the couple's cultural beliefs make this a challenge. This case illustrates the impact of post-partum hemorrhage in a developing world context and cultural issues related to sterilization performed in these settings to protect the life of the mother.


Post-partum hemorrhage, Sterilization, Uterine tamponade

Full Text:



Etches D, Hecox K. Post-partum hemorrhage. In: Dresang LT, Leeman L, Gipson TF, eds. Global Advanced Life Support in Obstetrics. 1st ed. Laewood, Kansas. American Academy of Family Physicians, 2009:70-6.

The Global Burden of Disease 2004 Update. Geneva, Switzerland: World Health Organization; 2008.

Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, et al. Priorities in Health. Washington, DC: The World Bank; 2006.

Skolnik, RL. Global Health 101. 2nd ed. Burlington, MA: Jones and Bartlett Learning. 2012:185-207.

WHO. Papua New Guinea Country Health Information Profile. Geneva, Switzerland: World Health Organization; 2011.

Leeman L. advanced life support in obstetrics course syllabus. Laewood, Kansas. American Academy of Family Physicians Section J; 2009.

Mola G. Manual of Standard Managements in Obstetrics and Gynecology for Doctors, H.E.O.s and Midwives in Papua New Guinea. 6th ed. Port Moresby, Papua New Guinea: National Department of Health; 2010:65-71.

The World Bank. Disease Control Priorities in Developing Countries. 2nd Edition. World Bank and Oxford University Press, New York, USA; 2006.