{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:26:50Z","timestamp":1789187210291,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,7,3]],"date-time":"2012-07-03T00:00:00Z","timestamp":1341273600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> Bimanual uterine compression may provide a reasonable treatment option for controlling or arresting postpartum hemorrhage in areas where access to care and advanced medical interventions are limited. Preliminary evidence suggests that correctly performed bimanual uterine compression is unsustainable for more than a few minutes, despite empirical evidence and practice recommendations that support extended compression for optimal effect. The objective of this study was to examine the impact of team\u2010based (pairs) bimanual uterine compression for managing postpartum hemorrhage from uterine atony.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Obstetricians, nurse\u2010midwives, midwifery students, and unskilled birth attendants (N = 30) in Ghana performed bimanual uterine compression using a simulator with objective performance feedback (6 lights) corresponding to pressure sensors on the uterus. For each participant, we tracked the degree and duration of maintained uterine compression. Birth attendants were then paired (15 pairs) and were similarly assessed performing the technique as a team, with 1 attendant providing external compression to the uterine fundus using 2 hands and the other providing internal pressure against the body of the uterus with a single hand.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Individuals were unable to fully compress the uterus and maintain compression for more than 150 seconds without fatiguing. All paired teams were able to fully compress the uterus and maintain the compression for the maximum allotted time of 5 minutes.<\/jats:p><jats:p><jats:bold>Discussion:<\/jats:bold> Results suggest that bimanual uterine compression is more effective when performed by a team, with a primary attendant maintaining internal lower uterine segment pressure and monitoring the patient's condition and a partner applying external pressure to the uterine fundus. For cases where access to advanced medical care is limited or delayed, team\u2010applied bimanual uterine compression could enhance the ability to control or arrest postpartum hemorrhage and increase the likelihood of maternal survival.<\/jats:p>","DOI":"10.1111\/j.1542-2011.2011.00152.x","type":"journal-article","created":{"date-parts":[[2012,7,4]],"date-time":"2012-07-04T20:30:40Z","timestamp":1341433840000},"page":"371-375","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Two\u2010Provider Technique for Bimanual Uterine Compression to Control Postpartum Hemorrhage"],"prefix":"10.1111","volume":"57","author":[{"given":"Pamela","family":"Andreatta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Perosky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy R.B.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,7,3]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-5-131"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-2011.2004.tb04420.x"},{"key":"e_1_2_9_4_2","first-page":"5.25","volume-title":"A Life\u2010saving Skills Manual for Midwives","author":"Marshall M","year":"2008"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)71090-4"},{"key":"e_1_2_9_6_2","volume-title":"Managing Complications in Pregnancy and Childbirth: a Guide for Midwives and Doctors","author":"World Health Organization","year":"2003"},{"key":"e_1_2_9_7_2","volume-title":"Joint statement: Prevention and Treatment of Post\u2010partum Haemorrhage: New Advances for Low Resource Settings","author":"International Confederation of Midwives, International Federation of Gynaecology and Obstetrics","year":"2006"},{"issue":"6","key":"e_1_2_9_8_2","first-page":"875","article-title":"Prevention and management of postpartum hemorrhage","volume":"75","author":"Anderson J","year":"2007","journal-title":"Am Fam Phys"},{"key":"e_1_2_9_9_2","first-page":"287","volume-title":"Postpartum Hemorrhage: A Comprehensive Guide to Evaluation, Management and Surgical Intervention","author":"B\u2010Lynch C","year":"2006"},{"issue":"4","key":"e_1_2_9_10_2","first-page":"266","article-title":"Bimanual uterine compression as a major technique in controlling severe postpartum hemorrhage from uterine atony","volume":"80","author":"Kovavisarch E","year":"1997","journal-title":"J Med Assoc Thai"},{"key":"e_1_2_9_11_2","first-page":"292","volume-title":"Obstetrics Emergencies","author":"Cavanagh P","year":"1982"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2004.06.017"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.06.038455"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0968-8080(04)24136-2"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/SIH.0b013e3181ebbcfd"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2011.03.001"},{"key":"e_1_2_9_17_2","first-page":"5.1\u20135.30","volume-title":"American College of Nurse\u2010Midwives Life Saving Skills: Manual for Midwives, Module 5","author":"American College of Nurse\u2010Midwives","year":"2008"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmwh.2009.09.016"}],"container-title":["Journal of Midwifery &amp; 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