NAIROBI, Kenya – The World Health Organisation (WHO) has unveiled landmark global guidelines to tackle postpartum haemorrhage (PPH) — the leading cause of maternal deaths worldwide — in a move experts say could save tens of thousands of women each year.
The new framework, launched jointly with the International Federation of Gynaecology and Obstetrics (FIGO) and the International Confederation of Midwives (ICM), consolidates evidence-based interventions into a single global standard focused entirely on preventing and treating PPH.
“Postpartum haemorrhage is the most dangerous complication of childbirth because it can escalate rapidly,” said Dr Jeremy Farrar, WHO Assistant Director-General for Health Promotion and Disease Prevention. “While it’s not always predictable, deaths are preventable with timely, appropriate care.”
Globally, more than 14 million women experience postpartum haemorrhage every year, with nearly 70,000 deaths — most of them in low- and middle-income countries. PPH accounts for roughly a quarter of all maternal deaths worldwide.
Kenya among hardest hit
In Kenya, postpartum haemorrhage remains one of the biggest threats to maternal survival.
According to WHO, about 10 women die every day from PPH-related complications — an estimated 5,000 deaths annually.
For every death, several others suffer severe complications such as organ failure, infertility, or long-term trauma.
“These deaths are not inevitable,” said Professor Anne Beatrice Kihara, President of FIGO. “With readiness, recognition, and rapid response, we can prevent most of them.”
Earlier diagnosis, faster treatment
The guidelines mark a major shift in how health workers detect and manage PPH. Previously, a woman was only diagnosed after losing 500 millilitres of blood.
The new threshold lowers this to 300 millilitres, combined with changes in vital signs, to trigger faster intervention.
Health workers are now urged to use calibrated drapes — simple, low-cost measuring tools that quantify blood loss immediately after birth — allowing earlier detection and treatment.
Once PPH is identified, providers are advised to implement the MOTIVE care bundle, which includes uterine massage, oxytocic drugs to induce contractions, tranexamic acid to reduce bleeding, intravenous fluids, examination for trauma or retained tissue, and timely escalation of care if bleeding continues.
In severe cases, surgical procedures or blood transfusion may be necessary.
Prevention at the heart of care
The WHO guidelines also emphasise prevention — tackling risk factors such as anaemia, which remains widespread among pregnant women in Kenya.
They recommend daily iron and folate supplements during pregnancy, and intravenous iron for women with severe deficiency.
Unsafe or outdated practices, such as routine episiotomies, are discouraged. Instead, providers are advised to promote perineal massage in late pregnancy and administer uterotonic drugs like oxytocin or carbetocin during labour to prevent bleeding.
Where injectable options or cold storage are unavailable, misoprostol may be used as a last resort.
“Midwives know first-hand how quickly postpartum haemorrhage can escalate and cost lives,” said Professor Jacqueline Dunkley-Bent OBE, Chief Midwife at ICM. “These guidelines are a game-changer. But we need governments and health systems to invest in midwives and maternal care to make this vision a reality.”
Tools for real-world impact
The rollout will be supported by training modules, simulation exercises, and national adaptation guides to help countries implement the new standards effectively.
These tools are especially critical in health systems such as Kenya’s, where workforce shortages, limited equipment, and delayed referrals continue to undermine maternal care.
The guidelines, launched during the 2025 FIGO World Congress in Cape Town, feature 51 recommendations that bring together the latest research and clinical best practices under the Global Roadmap to Combat Postpartum Haemorrhage (2023–2030).
