By The PPH Foundation

Postpartum haemorrhage remains the leading cause of maternal death worldwide, and in many cases, the risk of excessive bleeding is established long before labour begins. Antenatal care offers a critical opportunity to identify conditions that predispose women to PPH, including undiagnosed cervical disease. Cervical abnormalities can interfere with normal labour, increase the likelihood of prolonged or obstructed delivery, and raise the risk of surgical intervention, all of which are strongly associated with severe postpartum bleeding.

When cervical disease is not detected during pregnancy, labour often becomes unpredictable. Emergency caesarean sections, traumatic deliveries, and unplanned procedures increase uterine atony and tissue trauma, two major contributors to PPH. The World Health Organization recognises that cervical assessment during pregnancy is safe and can inform delivery planning, referral decisions, and preparedness for bleeding management.

Prof Moses Obimbo, Project Lead of the End Postpartum Haemorrhage Initiative, explains that “PPH is rarely a random event. It is frequently the final outcome of risks that were visible during pregnancy but not acted upon.” Implemented by the PPH Foundation in collaboration with the University of Nairobi, the Kenya Obstetrical and Gynaecological Society, and the Midwives Association of Kenya, the End PPH Initiative promotes antenatal screening as a core strategy for reducing bleeding-related maternal deaths.

By strengthening antenatal cervical screening, health systems can anticipate complications, reduce emergency interventions, and lower the incidence of postpartum haemorrhage before it occurs.

Sources
World Health Organization, Cervical cancer screening guidelines
UNFPA, Antenatal care and prevention of maternal mortality
BMC Women’s Health, Cervical screening uptake in Kenya

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