Global Health Agencies Issue New Guidelines to Curb Postpartum Deaths

Global health agencies have launched landmark new guidelines to improve the prevention, detection, and treatment of postpartum haemorrhage (PPH), the leading cause of maternal death worldwide.

The World Health Organization (WHO), the International Federation of Gynecology and Obstetrics (FIGO) and the International Confederation of Midwives (ICM) unveiled the recommendations during the 2025 FIGO World Congress in Cape Town. They call for earlier diagnosis and faster intervention to save the lives of tens of thousands of women who die each year from excessive bleeding after childbirth.

“Postpartum haemorrhage is the most dangerous childbirth complication because it can escalate with alarming speed,” said Dr. Jeremy Farrar, WHO Assistant Director-General for Health Promotion and Disease Prevention and Care. “These guidelines are designed to save lives where the burden is highest and resources are most limited.”

PPH affects millions of women annually and causes about 45,000 deaths. Traditionally, it has been diagnosed when blood loss exceeds 500 millilitres. Under the new guidelines, health workers are urged to act once blood loss reaches 300 millilitres, especially if the mother shows abnormal vital signs.

The use of calibrated drapes is recommended to measure blood loss more accurately and enable a quicker response. Once PPH is diagnosed, providers should immediately implement the MOTIVE bundle of actions: massaging the uterus to stimulate contractions, administering oxytocic drugs and tranexamic acid (TXA) to reduce bleeding, providing intravenous fluids, examining the genital tract for injury, and escalating care if bleeding continues.

“Women affected by PPH need care that is fast, feasible and effective,” said Professor Anne Beatrice Kihara, FIGO President. “These guidelines promote readiness, recognition and response, empowering health workers to act quickly and save lives.”

The guidelines also stress prevention through better antenatal and postnatal care. Treating anaemia with iron and folate supplements during pregnancy and discouraging unsafe practices such as routine episiotomies are among key recommendations.

“Midwives know first-hand how quickly postpartum haemorrhage can cost lives,” said Professor Jacqueline Dunkley-Bent OBE, ICM Chief Midwife. “These guidelines are a game-changer, but governments must invest in midwives and maternal care to make them work.”

The publication is part of the Global Roadmap to Combat Postpartum Haemorrhage (2023–2030) and includes training resources developed with UNFPA to help countries adopt the new practices.