Surgical masks were more effective than paper sanitary pads at preventing women’s blood from clotting during vaginal birth, a study shows. But masks are cheap, require no washing and carry no known risk of contamination.
Smokers are 20 times more likely to suffer a blood clot during birth or after childbirth. But earlier studies have shown that paper and cloth from a pap smear – usually used for examining women’s cervixes, genitals and breasts – are effective, less time-consuming and safer for breastfeeding mothers than suture-like surgical masks, doctors said.
A small study in Perth in Australia found that surgical masks were at least twice as effective at preventing blood clots in women giving birth than paper sanitary pads, which must be washed.
Melinda Persson, an obstetrician at the Royal Women’s Hospital in Adelaide, said more research was needed to understand why surgical masks had a higher success rate. “Everyone uses the suture masks, for example when an episiotomy [vaginal cutting] is made,” she said.
“The same hospital did a major trial with the surgical masks and the paper pads. We were all hoping that surgical masks would be more effective, but in the end it wasn’t that much better,” she said. Persson co-wrote a review of the evidence on pregnancy clotting published in December. Her study is one of the few looking at surgical masks.
In the UK, 69,000 vaginal births, nearly one in three of all births, end in the baby being readmitted to hospital with haemorrhage, said Brenda Flanagan, a consultant gynaecologist at the London Women’s and Mount Vernon hospitals. The highest risk is to mothers who smoke.
Most women require vaginal birth when their cervix is a mere half-inch dilated. But one in 10 of the women who are transferred to theatre for delivery also needs blood clotting medication, she said.
Flanagan said the study showed that because surgical masks had more difficulty trapping and absorbing blood, they were more effective in preventing clots than paper pads. Not all hospitals use surgical masks, which are the equivalent of a pair of scissors. If a blood clot happens, the cloth or paper pads they came in can rapidly clot the blood, which makes it harder to remove.
Doctors say the take-up of surgical masks is higher in poorer communities and across ethnicity and age groups than in the UK. The study showed they were at least twice as effective at preventing blood clots compared with paper pads.
“Pap smears are quite messy, so they’re not part of the everyday practice for the first part of pregnancy,” said Greg Hardy, a consultant gynaecologist at Guy’s and St Thomas’ NHS Foundation Trust, who co-wrote the review. “So some of these women might be better able to access a surgical mask.” He also said older women might need a surgical mask while in hospital for maintenance, routine observations or have strong smell of urine.
But he added: “I don’t want to suggest that women should now not smear pap smears because surgical masks are a better method to block blood clotting.”
Women still need to use Pap smears and smear tests because they offer the best method of early detection, he said. They may feel they are more vulnerable to blood clots because they may have performed some form of surgery during their pregnancy.