Haleema Shakur Still

But she couldn't convince the doctors who were primarily male in Japan

to do the trials needed to see whether it could save the lives of women.

So for most of its early life, tranexamic acid was used for minor bleeds like tooth extraction, minor surgery, et cetera.

Eventually, 50 years later, was when we did the study, the woman trial, that fulfilled her original dream of looking at tranexamic acid as a treatment for postpartum hemorrhage.

Postpartum hemorrhage is a very complex thing, but it's basically any bleeding that could lead to a life being threatened after childbirth.

The women trial setup was absolutely amazing because we were only used to doing trauma trials.

I thought setting up a maternal health trial would be really difficult because we needed lots of doctors and midwives and nurses around the world, especially in countries where maternal death rates were very high to take part in this trial.

And it was absolutely amazing that we sent letters of invitation out and we had no problems because almost everyone felt we needed better treatments for these women.

If we use that woman as an example, she had given birth at home.

The family had rushed her to a local hospital that did not have the facilities to look after her, and then she was taken to this teaching hospital.

So by the time she got to that hospital, it was several hours after giving birth, she had been bleeding for several hours.

So the time delay was enormous and she had bled out too much.

And with bleeding, most of the bleeding happens really early.

So you need to intervene really early.

I think it's a mixture of things because in the woman trial, almost all the women gave birth in hospital and still women went on to die.

There are many reasons why women might develop postpartum haemorrhage.

Skipping to our woman two trial, we show that if you're anemic, you're more likely to develop postpartum haemorrhage.

If you have had sort of multiple births, if you sort of age, there are so many factors, but we're still not really sure about, you know, why some women bleed.

and why some don't.

So the initial idea and concept came about from discussion with doctors, particularly in Nigeria, because that was where the whole story started.