How the male condom saves Kenyan mothers from bleeding to death
In a quiet homestead in Kosinyo village, Siaya County, Kenya, Lilian Achieng Omondi rocks her two-month old baby. Her first born, seven, sits next to his mother as though to get a glimpse of the young one who is about to sleep. Their brother, two, is playing outside the house. All three children are clearly oblivious of the challenges that their mother has undergone to give birth to them.
Achieng, 28, has experienced post-partum haemorrhage since giving birth to her first born son. Postpartum haemorrhage, a condition that leads to excessive bleeding in some women immediately after giving birth contributes to 287,000 deaths in Kenya alone. This is 34 percent of overall maternal deaths.
For her first birth in 2011, Achieng experienced minimal complications and bleeding thereafter. “I had a smooth delivery of my first born baby. Although I experienced some bleeding, I was injected and my body stabilised,” she remembers.
Five years later, she would undergo the same experience for her second birth. But this time, she remembers, the bleeding got worse. Unaware of the solution to her problem, Achieng sought help at a nearby health facility. Here, she was injected, and just like in the first delivery, the bleeding stopped.
The birth of her third born on December 7, 2017 was the most complicated. “I experienced heavy bleeding and the injection did not help this time. It started with very painful labour that lasted about five hours.” Achieng took herself to a health facility at 06:00 and delivered at 12:30.
“I saw my baby, breastfed her and immediately I became unconscious,” she recalls. Achieng would then experience excessive bleeding. She was taken to another health centre – Akala Health Centre – where she regained consciousness. “When I woke up, I noticed something strange in my body. The doctor was removing some water from my body using a syringe. It was not painful. At this time, I had gained conscience and the bleeding had stopped,” she explains.
It was the Uterine Balloon Tamponade (UBT) kit that was used to stop Achieng’s excessive bleeding. The kit is a locally assembled package by the Kisumu Medical and Education Trust (KMET) that is aimed at addressing postpartum haemorrhage. The kit consists of a pair of condoms, a rubber catheter, a string, two data cards, a referral card and a 60ml syringe. The card is meant to record details of the mother including her name, physical address and comments by the health worker regarding their experience in using the UBT device.
How it works
The UBT kit is used on women who experience postpartum bleeding. One of the condoms in the pack is tied to the catheter using a cotton string. It is then inserted in the on the uterine wall of the bleeding mother. Water is then continually pumped into the uterus to stop the bleeding. At the same time, the heath officer keeps pumping water into the balloon. This is done using a 60ml.
This applies pressure on the uterine wall hence stopping the bleeding. Once the bleeding stops, the balloon is left in the mother’s uterus between 24 and 36 hours. The mother is then given antibiotics to prevent any infections.
To remove the balloon, one has to first remove the water from the condom that is already inserted in the woman’s uterus. This deflates the balloon. Just the same way the water was pumped into the balloon in bits, it is removed in bits using the syringe. After all water is removed, the catheter and the balloon are then removed from the mother’s uterus.
According to Dr. Chris Opati, the Clinical Officer at the Akala Health Centre in Siaya County, the UBT kit has so far saved the lives of two women, including Achieng, in the health centre. He says it can be used for women who have had a natural birth as well as those who have undergone a caesarean section. However, the kit can only be administered by a qualified health officer at a health centre.
Dr. Opati, however, says the balloon has to be left inside the uterus for at least 24 to 36 hours for maximum impact. So far, Akala health centre has used the kit on two women.
According to Saving Mothers Lives 2017, First Confidential Report into Maternal Deaths in Kenya, 42 percent of maternal deaths reported in the District Health Information System (DHIS) for the year 2014 involved women who were having their first or second pregnancy. The report by the ministry of health records that two out of five women died due to excessive bleeding during child birth.
Immaculate Otieno, project officer and trainer of at KMET says the kit has already been used in Kisumu, Siaya, Bungoma, Garissa, Isiolo, Turkana, Mandera, Homabay, Wajir and Nakuru among other counties.
According to her, the UBT kit is easy to use by any cadre of health worker. The kits were first used in Kenya in 2012 with a pilot in five counties. To date, the KMET UBT kits are being used in 15 counties. A complete kit costs Sh1,000.