Nepal James Tielsch
PhD Program, Department of International Health, JHSPH
?The goal of this study is to gain a better understanding of current cultural norms and attitudes around use of uterotonics during labor and delivery, perceptions of the risks and benefits of these drugs, as well as the decision-making process that is driving the widespread use of uterotonics in a community-setting in rural, southern Nepal. Effective uterotonics, agents such as oxytocin and misoprostol that are used to induce or speed up labor as well as to stop bleeding after delivery, have been used to ease labor and delivery and to prevent or mitigate complications for decades. When used inappropriately, however, these same uterotonics can have serious adverse effects. Home use of uterotonics before the baby is born where skilled provision and proper monitoring of danger signs are lacking is thought to be unsafe for both mothers and newborns. In low-income countries like Nepal, injectable uterotonics are widely available without a prescription or instruction on proper use. This study will employ qualitative methods including focus groups and in-depth interviews of women, family members, traditional birth attendants, local (non-qualified) doctors, and trained healthcare providers.
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