Table 2 Awa’s story

Awa is a 30 year old pregnant woman. This is her fifth pregnancy, she has three living children and an early neonatal death in her fourth pregnancy. She gave birth with great difficulty the last time.

We receive her at the Sominé Dolo Hospital in Mopti on April 11, 2019 at 7:30 pm. She was evacuated from the health district of Bankass located 130 km from our hospital for uterine rupture. She did not make any prenatal visit. She has been in labor for 2 days at home. After the failed attempt to deliver at home, she was brought to the reference health centre in Bankass by animal-drawn cart. The diagnosis of uterine rupture was made and she arrived at the Sominé Dolo hospital by ambulance after a 3-h journey. She was very anemic, accompanied by her very elderly mother-in-law who was unable to give blood and weak. Her husband’s brother had to leave his village to come the next day. We performed a subtotal hysterectomy. She received a single bag of blood that belongs to another patient. She died 1 h after the operation. There were no other blood bag available for her.