Prevention of postpartum haemorrhage at community level: which uterotonic?

Despite a substantial reduction in global maternal deaths due to postpartum haemorrhage between 1990 and 2013 (from 71 295 to 44 190), this condition continues to be the main cause of maternal mortality worldwide.1 In sub-Saharan Africa and south Asia, many women still deliver at home without a skilled attendant, or attended by low-level providers in facilities with limited resources.2 In these contexts, availability of uterotonics that are easy to administer and are stable in field conditions are fundamental to decrease the morbidity and mortality of postpartum haemorrhage.