Quality of carein control sites, as measured through birth attendant adherence to practices, wasfar lower than previously recognized.16,25,37-41Overall, birth attendants in non-intervention facilities performed just 40% ofmeasured essential practices in a typical birth, such as appropriate hand hygiene(used in >1% of deliveries) or administration of oxytocin within the firstminute postpartum to reduce hemorrhage (used in >25%). This evidence concerns the gene OXT and hemorrhage.