The Blood Clock, a unique art installation created for the WOMAN trial to raise awareness of postpartum haemorrhage and the need for urgent treatment, is being unveiled at the London School of Hygiene & Tropical Medicine. It was designed and made by Consultant Obstetrician Dr Graham Tydeman, who regularly deals with the problem of blood loss in childbirth. Every six minutes, somewhere in the world, a woman dies from PPH. Dr Tydeman’s installation graphically illustrates the number of deaths in a striking and thought provoking way, both telling the time and counting deaths.
The two-metre high brass and clear acrylic Blood Clock is a mechanical sculpture using materials gathered from maternity wards or inspired by the issue of PPH and the tranexamic acid research. Fake blood fills newborn baby cots discarded by a maternity hospital – this then tips out every six minutes moving the hands of the clock, which represents a woman bleeding to death. A digital display counts the total number of deaths.
Dr Tydeman made the Blood Clock in his workshop at his home in Fife, Scotland, taking inspiration from his day job as consultant and clinical lead in the department of obstetrics and gynaecology, NHS Fife.
He said: “PPH is challenging to predict and treat at the best of times, but in countries with limited health facilities and blood supplies the outcomes for women are far worse. Scientific evidence is vital in enabling doctors to save lives.
“We now know that tranexamic acid is safe and effective but must be given urgently - I hope the Blood Clock will help convey the importance of the WOMAN trial findings and the need for timely treatment.”
Design elements of the clock:
· Tranexamic acid was invented in Japan and the energy for the movement of the hands comes from a traditional Japanese fountain: sishi odoshi.
· The fake blood was donated by Pigs Might Fly after a close friend of the company boss experienced a major PPH.
· Massive PPH is often defined as 2.5 litres. The blood clock trickles 2.5 litres into the sishi odoshi fountain before it tips. The energy from each tip moves the minute hand on another six minutes and in doing so, counts off another woman’s death.
· The blood drips out of a large Hegar dilator – an instrument used to stretch open the cervix in order remove pieces of placenta after childbirth: retained placenta is a common cause of PPH.
· Two surgical retractors (Doyen and Morris) that are commonly used in Caesarean section or hysterectomy, dictate the amount of blood that pours before each tip of the fountain.
· The blood is stored in four newborn baby cots discarded from an old maternity hospital, along with most of the plumbing fittings. In the WOMAN trial the average birth rate was 4 babies per woman.
· Part of the collecting system uses a cell saver, expensive technology only available in high-income healthcare settings, where blood the woman has lost is washed and transfused – so she receives her own blood back.
· The clock gears are from an old church clock from 1861 built in Clerkenwell, near where the first UK maternity ‘lying in’ hospital had been established.
The Blood Clock is being launched at a special event on 9 November and will remain on display at the London School of Hygiene & Tropical Medicine until February 2018
