Every 12 minutes, a woman dies from postpartum haemorrhage, making it the world's leading direct cause of maternal death. Yet many of these deaths could be prevented through earlier diagnosis, faster treatment, and wider access to proven interventions.
A major new three-part Lancet Series, led by researchers from the University of Oxford, brings together the latest evidence on postpartum haemorrhage and sets out a roadmap for reducing its devastating impact. The Series highlights practical, affordable measures that could save thousands of lives every year.
Professor Arri Coomarasamy, Professor of Gynaecology and Reproductive Medicine at the University of Oxford and co-author of the Series, said: "Every maternal death from postpartum haemorrhage is a tragedy, and most are preventable. Our research shows that we already have the tools needed to save thousands of lives. What is needed now is urgent action to ensure these proven interventions reach every woman, everywhere."
PAPER 1: The devastation of postpartum haemorrhage
The first paper in the Series examines the scale and impact of postpartum haemorrhage worldwide.
The researchers estimate that postpartum haemorrhage affects around 27 million women every year and causes nearly 43,000 maternal deaths. The burden falls disproportionately on women in low- and middle-income countries, particularly in sub-Saharan Africa and parts of Asia.
Beyond the human cost, postpartum haemorrhage places a significant strain on families, health systems and national economies. The Series estimates the annual economic burden exceeds US$10 billion globally.
The findings underline the urgent need for action to improve maternal health outcomes and strengthen health systems worldwide.
PAPER 2: Preventing postpartum haemorrhage - what can we do?
The second paper focuses on prevention and highlights opportunities to reduce the risk of severe bleeding before childbirth even begins.
The authors call for a life-course approach that includes improving access to contraception, reducing anaemia, strengthening antenatal care, and avoiding medically unnecessary caesarean sections. They also emphasise the importance of ensuring all women receive effective uterotonic medicines, such as oxytocin, after birth to help prevent excessive bleeding.
The paper concludes that prevention requires more than clinical guidelines alone. Strong health systems, reliable medicine supplies, and a well-trained workforce are essential for delivering effective care.
PAPER 3: Winning the race against time
The third paper describes postpartum haemorrhage as a race against time, where delays in diagnosis and treatment can quickly become life-threatening.
The researchers found that visual estimation of blood loss misses more than half of postpartum haemorrhage cases. They recommend replacing visual estimates with objective measurement tools, such as calibrated blood collection drapes, which enable earlier and more accurate diagnosis.
The Series also highlights a simple first-response treatment bundle known as MOTIVE. This approach combines five evidence-based interventions delivered immediately after diagnosis and has been shown to reduce progression to severe haemorrhage by up to 60%. The authors identify six critical delays in care - from diagnosis and treatment to escalation and access to blood products - and argue that addressing these delays could dramatically improve survival.
With effective medicines, simple diagnostic tools and proven treatment strategies already available, the message from the Series is clear: many deaths from postpartum haemorrhage can be prevented through timely action and well-prepared health systems.
Key recommendations from The Lancet Series
The Series calls for coordinated action across healthcare systems and governments worldwide, including:
- Prevent, diagnose and treat anaemia before and during pregnancy.
- Improve access to antenatal care and address modifiable risk factors such as unnecessary caesarean sections.
- Ensure all women receive quality-assured uterotonic medicines after birth.
- Replace visual estimation of blood loss with objective measurement methods.
- Adopt the WHO-FIGO-ICM definition of postpartum haemorrhage to enable earlier diagnosis.
- Implement the MOTIVE treatment bundle as the standard first response to postpartum haemorrhage.
- Reduce delays in diagnosis, treatment, escalation of care and access to blood products.
Publication
The Lancet Series on postpartum haemorrhage is published in The Lancet.
https://doi.org/10.1016/S0140-6736(26)00902-5
https://doi.org/10.1016/S0140-6736(26)00903-7
https://doi.org/10.1016/S0140-6736(26)01031-7
For further information, or media enquiries, please contact:
Rob Phillips, Communications Manager (communications@wrh.ox.ac.uk)
Nuffield Department of Women’s & Reproductive Health
Related links
- https://www.who.int/initiatives/elimination-of-deaths-from-postpartum-haemorrhage
- WHO health topic: Maternal health
- https://www.who.int/news-room/fact-sheets/detail/maternal-mortality
- WHO publication: Consolidated guidelines for the prevention, diagnosis and treatment of postpartum haemorrhage
- Consolidated guidelines for the prevention, diagnosis and treatment of postpartum haemorrhage: implementation guide