Dear HIFA colleagues,
I’m grateful to join this global community of healthcare professionals committed to equitable access to lifesaving knowledge. I’d like to share a simple, low-cost technique we’ve developed for managing postpartum hemorrhage (PPH) and post-abortion bleeding — one that may be especially useful in resource-constrained environments.
FOCUS (Foley Catheter for Uterine Suction) is a non-commercial, off-label technique that repurposes a standard Foley catheter connected to gentle suction to control hemorrhage through vacuum-induced uterine tamponade. It mimics the physiologic mechanism of uterine contraction, similar to commercial devices like the JADA system, but with equipment already available in nearly every delivery room or emergency setting.
We’ve used the method in U.S. hospitals with excellent results, including cases where medical management, or balloon tamponade failed, or where JADA was inappropriate due to the lack of cervical dilation (e.g. post-cesarean or early gestation). The technique has recently been published in AJOG (https://www.ajog.org/article/S0002-9378(25)00447-8/abstract).
* Free training resources (videos, multilingual printable instructions, case series, article preprints, and clinical guidance) are available at www.focuspph.com.
* Call for collaboration: We maintain a prospective registry and are actively seeking global partners, especially in LMICs and high-volume maternity centers, to document use and outcomes of this technique.
* We also welcome your feedback, use, and local adaptation of the technique.
If this is of interest to you, your colleagues, or your institution, I would be happy to share more or arrange a brief call, or share the article pdfs directly with you. Please also feel free to circulate the website link among maternal health providers in your network.
How FOCUS Is Performed
1. Clear the uterine cavity of any clots or retained products using suction curettage or manual removal.
2. Insert a Foley catheter (typically 16–24 French depending on uterine size) into the uterus, advancing the balloon just past the internal cervical os.
3. Inflate the balloon with 30–35 mL of sterile saline to anchor it in place.
4. Connect the catheter lumen to low-pressure wall suction (starting at ~80 mmHg or ~10.7 kPa), increasing gradually as needed to a maximum of 525mmHg. Suction tubing and a standard collection canister are used.
5. Maintain suction for 1–24 hours, depending on bleeding severity and response.
6. Administer antibiotics (e.g., azithromycin + cefazolin postpartum or doxycycline post-abortion or misscariage).
7. Once bleeding stabilizes, deflate the balloon, pause suction, and remove the catheter after ensuring no recurrence.
This technique provides negative pressure that promotes uterine contraction from within, functioning similarly to commercial vacuum-induced tamponade systems, but using widely available materials.
More details, illustrations, and printable PDFs are available at www.focuspph.com.
With appreciation,
Frank Jackson, DO
HIFA profile: Frank Jackson is a Physician at the University of New England, in the United States. Professional interests: OBGYN, Maternal Fetal Medicine, Postpartum hemorrhage, Foley catheter for uterine suction (FOCUS).
Email: fjackson AT une.edu