Objective To examine potentially modifiable factors that may influence the high maternal and perinatal mortality associated with caesarean section in Malawi.

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SummaryA prospective study of mothers needing Caesarean section was undertaken to examine the need for blood transfusion, the actual number of units given and the effectiveness of blood transfusion in preventing maternal mortality. Of 3665 mothers in 22 hospitals in Malawi, 11.1% were assessed as needing a transfusion and 7.2% were transfused. There were significant differences between district and central hospitals in transfusion rates. Of those mothers who were considered to need blood, there was no significant difference in mortality between those who received a transfusion and those who did not.

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