By PPH Foundation
Postpartum haemorrhage (PPH) isn’t confined to the delivery room; it can occur hours or even days after a mother leaves a health facility, making postnatal monitoring and follow‑up essential for survival. Close observation in the first hours and days after birth enables early detection of excessive bleeding, allowing lifesaving interventions before complications escalate. Early home visits and community support are critical, especially where formal postpartum monitoring is limited.
Data from a study in Uganda showed that irregular postpartum checks were linked with higher rates of complications. Among women observed, postpartum complications occurred in 14.1 percent, with 67.6 percent of these being PPH, and mothers without early checks were significantly more likely to experience adverse outcomes. A direct observation study in Kenya also found gaps in postpartum monitoring, noting that providers failed to follow postpartum care guidelines during facility discharge, highlighting risks after leaving care settings.
These findings align with updated global recommendations from the World Health Organization, which stress that early and frequent postpartum assessment; including checking vital signs and quantifying blood loss, is essential to identify abnormalities before they become life‑threatening. WHO guidance underscores that most PPH cases happen in the first hours after birth and that systematic monitoring improves early recognition and response.
Community health workers and home visits are powerful tools in bridging monitoring gaps after discharge. Research on resource‑limited settings shows that involving community health workers, traditional birth attendants, and women’s groups can improve early detection and expedite referral for emergency care when complications arise.
Prof Moses Obimbo, the End PPH Initiative Project Lead, reinforces this message: “PPH can develop silently after discharge. Early, structured follow‑up; from facility to community, is lifesaving. Skilled care does not end at discharge; it continues through vigilant monitoring and timely action.”
Postnatal follow‑up, whether through home visits, telehealth check‑ins, or strengthened community health outreach, is not a luxury, but a critical component of maternal survival. Detecting danger signs early, educating families on warning symptoms, and ensuring quick access to emergency care can turn potential tragedy into healthier beginnings for mothers and their babies.
Sources
Waiswa P, Kallander K, Peterson S, Tomson G, Pariyo GW. Using the three delays model to understand why newborn babies die in eastern Uganda. BMC Pregnancy and Childbirth, 2010, 10(1)
Opondo C, Allen E, Todd J, English M. The quality of inpatient care for newborns in Kenya, a direct observational study. PLOS ONE, 2015, 10(5)
World Health Organization. WHO recommendations on maternal and newborn care for a positive postnatal experience. Geneva, World Health Organization, 2022
Lassi ZS, Haider BA, Bhutta ZA. Community-based intervention packages for reducing maternal and neonatal morbidity and mortality and improving neonatal outcomes. Cochrane Database of Systematic Reviews, 2010, Issue 11
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