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Midwives in training help deliver babies under the supervision of the head midwife, Afghanistan.
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Elimination of deaths from postpartum haemorrhage

Preventing, detecting and treating the leading cause of maternal mortality

Severe bleeding after childbirth – postpartum haemorrhage (PPH) – is the leading cause of maternal mortality world-wide. Each year, about 14 million women experience PPH resulting in about 70 000 maternal deaths globally. Even when women survive, they often need urgent surgical interventions to control the bleeding and may be left with lifelong disability.

Immediate intervention is needed to eliminate deaths due to PPH. Despite the ambition to end preventable maternal deaths by 2030, many countries are not on track to meet their maternal mortality targets, which are part of Sustainable Development Goal 3 (SDG 3). Alarmingly, progress in reducing maternal mortality has stalled over the past 5–10 years. This stagnation means that without rethinking current approaches and taking appropriate actions at global and national levels, the 2030 MMR target will not be met.

This is why stakeholders in the field came together to develop a roadmap to eliminate PPH between 2023 and 2030. The Roadmap aims to align efforts by providing a strategic framework to address PPH-related challenges and accelerate progress toward achieving the Sustainable Development Goal of reducing maternal mortality by 2030. 

 

A Roadmap to combat postpartum haemorrhage between 2023 and 2030

Objectives


Align stakeholders

Unite global actors around shared priorities and actions to address PPH.

Focus efforts

Eliminate duplication of work and concentrate on key activities to tackle PPH effectively.

Accelerate progress

Engage stakeholders to urgently advance PPH prevention and care globally and locally.

Partners

While international developmental partners tend to have similar objectives regarding PPH priorities, efforts are often misaligned because of a lack of cohesive coordination at the global and country levels, as well as a lack of end-to-end thinking as it pertains to product development, introduction, and impact assessment.

Academic researchers and innovators in industry often do not know what type of evidence to generate and how to connect evidence to policy decision-making, leading to a lot of research waste, and a painfully slow process of translating research ideas to clinical impact at the patient level.

Likewise, target product profiles (TPP) have not generally been described prior to R & D of PPH interventions, and the concept of target policy profiles (TPop) (to identify key research questions to support policy changes at the point of evidence generation and dissemination) is relatively new to those who make research funding decisions. In short, there is no clarity on what is in the pipeline regarding PPH products or interventions, or on what an ideal future PPH products or policy requirements should look like. 

In recognition of the need for global action to improve the quality of PPH care, WHO and HRP convened a PPH Summit from 7 to 10 March 2023 to bring together all relevant stakeholders – ministries of health, academic institutions, non-governmental organizations, healthcare professional associations, industry and private sector, UN agencies and international donors – to review and prioritize the most urgent PPH priorities to fast-track progress towards SDG 3.1 target in terms of research, guidelines, advocacy and country-level implementation. 

 

International Confederation of Midwifes (ICM) logo

University of Birmingham logo

Unitaid Save lives faster logo

Gates Foundation logo black and white

MSD for Mothers logo teal and grey

International Federation of Gynecology and Obstetrics (FIGO) logo
 

Call to action


WHO is developing tools to aid adaptation of the Roadmap for use in local contexts, including an evidence brief on implementation of the Roadmap in the most affected regions and countries. The Roadmap and tools will be disseminated through WHO regional and country offices, ministries of health, professional organizations, WHO collaborating centres, other United Nations agencies, CSOs and NGOs, among others.  

In addition, journal articles presenting each strategic area (including development and identification of priorities) and key implementation considerations will be prepared for publication in peer-reviewed journals, in compliance with WHO’s open access and copyright policies. Relevant WHO clusters and departments, and partnerships, such as the Partnership for Maternal, Newborn and Child Health (PMNCH), will also be part of this dissemination process. 

To ensure these efforts have an impact on maternal health at the country level, coordinated action between international agencies, ministries of health and key maternal and perinatal health stakeholders is required. WHO staff at headquarters, regional and country level, as well as international agency partners and international professional societies (e.g. FIGO, ICM and national professional associations) can support national stakeholders in developing or revising existing national guidelines or protocols, and optimizing their implementation in response to the Roadmap.

Context-specific tools and toolkits may be required in addition to standard tools to support stakeholders to implement the Roadmap recommendations in the context of humanitarian crises. 

Publication


WHO recommendations on the 
assessment of postpartum blood 
loss and use of a treatment bundle 
for postpartum haemorrhage
This document issues an updated recommendation on the assessment of PPH and a new recommendation on the use of a treatment bundle for the management of...

 

Journal articles

Bohren MA, Miller S, Mammoliti KM, et al. Early detection and a treatment bundle strategy for postpartum haemorrhage: a mixed-methods process evaluation.Lancet Glob Health. 2025;13(2):e329-e344. doi:10.1016/S2214-109X(24)00454-6

Gallos I, Devall A, Martin J, et al. Randomized Trial of Early Detection and Treatment of Postpartum Hemorrhage. N Engl J Med. 2023;389(1):11-21. doi:10.1056/NEJMoa2303966

Widmer M, Piaggio G, Nguyen TMH, et al. Heat-Stable Carbetocin versus Oxytocin to Prevent Hemorrhage after Vaginal Birth. N Engl J Med. 2018;379(8):743-752. doi:10.1056/NEJMoa1805489

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