The World Health Organization (WHO) released its first roadmap to tackle postpartum hemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
A woman is estimated to die every two minutes from causes relating to pregnancy or childbirth. There has been limited progress in reducing these deaths since 2015 and the world is off-track for meeting related Sustainable Development Goal targets.
The Roadmap to combat postpartum hemorrhage between 2023 and 2030 outlines goals and activities for research, normative work, implementation and advocacy.
Priority actions include: the development of new and broader guidance for PPH covering prevention, detection and treatment; research to deliver innovations and to increase access to proven interventions; the establishment of a new procurement mechanism to improve the supply of high-quality medicines and commodities; advocacy and awareness-building, and, at the country level, training and facility-based improvements.
The Roadmap was developed through extensive consultations involving more than 130 experts across diverse fields, while implementation will be guided by an interdisciplinary steering committee.
WHO and partners will provide specialized technical support to countries to adapt global guidelines into national policies, starting where there is the highest burden of maternal deaths.