By The PPH Foundation

New global efforts to prevent and treat postpartum haemorrhage, a leading cause of maternal deaths, are transforming the way childbirth emergencies are managed. The World Health Organization has released updated guidelines that redefine how bleeding after childbirth should be detected and treated, urging all countries to adopt faster, coordinated responses.

According to WHO, postpartum haemorrhage remains responsible for more than one in five maternal deaths worldwide, despite being largely preventable. The organization’s latest 2023 recommendations call for early action once blood loss reaches 300 millilitres or when a woman shows signs of shock, a major shift from previous thresholds that waited for more severe bleeding. This approach aims to save lives by ensuring treatment begins before a woman’s condition deteriorates.

A key feature of the new guidelines is the introduction of the PPH treatment bundle, a combination of proven interventions applied simultaneously rather than one after another. The bundle includes administering uterotonic drugs such as oxytocin, performing uterine massage, giving tranexamic acid within three hours of birth, and providing intravenous fluids or blood transfusions as needed. This integrated approach has been shown to improve recovery and reduce maternal deaths significantly.

Professor Moses Obimbo, the e-PPH Initiative Project Lead at PPH Foundation, notes that the shift to a bundled approach is a critical advancement. “By acting quickly and using multiple lifesaving tools together, healthcare providers can stabilize a woman’s condition faster,” he says. “This coordinated model improves outcomes and simplifies training for frontline staff.”

In addition to the bundle, WHO now recommends objective measurement of blood loss using calibrated drapes or collection devices rather than relying on visual estimation. This innovation allows midwives and doctors to detect bleeding early and respond with precision. In Kenya, Prof Zahida Qureshi of the University of Nairobi has pioneered the use of locally produced calibrated drapes, an affordable tool now being adopted in several counties to improve early detection of PPH. “Postpartum Hemorrhage is a ticking clock. The longer you take to recognize it, the less chances you have to reverse the woman out of it,” she says. The innovation has been praised for its practicality and potential to save lives in resource-limited settings.

Technological innovations are also reshaping PPH management worldwide. Low-cost uterine balloon tamponades, portable blood collection drapes, and digital tools for real-time monitoring are being introduced in health facilities across Africa. In Kenya, several counties are piloting these devices through partnerships supported by the Ministry of Health and the PPH Foundation.

Dr Frederick Kireki Omanwa, Consultant Obstetrician and Gynaecologist and President of KOGS, says technology and training must go hand in hand. “Innovation is powerful only when it reaches the woman in need. Every maternity ward should have access to these tools and the skills to use them effectively,” he says.

Professor Ann Kihara, a co-lead at the End PPH Initiatiave, adds that the new WHO guidelines mark a turning point in maternal health. “By standardizing how bleeding is assessed and treated, we can reduce global disparities and move closer to ending preventable maternal deaths,” she observes.

The WHO’s Roadmap to Combat Postpartum Haemorrhage 2023–2030 outlines a vision where no woman dies from preventable bleeding. For Kenya and other countries in the region, adopting these global standards, investing in innovation, and empowering healthcare providers could make that vision a reality.

Photo by Jonathan Borba: https://www.pexels.com/photo/baby-beside-woman-3259628/

Sources
• World Health Organization, WHO Recommendations on the Assessment of Postpartum Blood Loss and Use of a Treatment Bundle for Postpartum Haemorrhage, 2023
• World Health Organization, A Roadmap to Combat Postpartum Haemorrhage 2023–2030
• University of Nairobi, Department of Obstetrics and Gynaecology, 2024: Innovation on Calibrated Blood-Loss Drapes by Prof Zahida Qureshi
• Kenya Ministry of Health, Maternal and Newborn Health Division Updates, 2024
• Kenya Obstetrical and Gynaecological Society, 2024 Updates on Maternal Health Practice