Labour Management: Oxytocin in the context of the Millennium Development Goals

The appropriate use of oxytocin, one of the drugs on which is the focus in the ‘Tracing Pharmaceuticals’ project, is directly linked to Millennium Development Goals 4 and 5 (relating to child mortality and maternal health). Safe Motherhood initiatives have included Active Management of Third Stage of Labour (AMTSL) as a central part of the strategy to reduce maternal and perinatal morbidity and mortality. Recommendations for AMTSL include the administration of oxytocin by intramuscular injection to help prevent post-partum haemorrhage (PPH), one of the key causes of maternal mortality throughout the developing world. Yet these proposals seem to ignore the realities of access to and use of medicines in the Global South. Many drugs, including oxytocin, have lives independent of policy interventions. In this paper, the authors argue that focusing on pharmaceuticals use ‘on the ground’ can illuminate some of the problematic relationships between labouring women’s experiences in the Global South and the policies put in place to ameliorate them.