## New Global Guidelines Aim to Halt Preventable deaths from Postpartum Haemorrhage
Global health agencies have released new consolidated guidelines focused specifically on preventing, diagnosing, and treating postpartum haemorrhage (PPH), a leading cause of maternal mortality.Launched at the 2025 FIGO World congress in Cape Town,South Africa,the guidelines represent a crucial step in implementing the WHO’s Global roadmap to combat postpartum haemorrhage between 2023 and 2030.
The 51 recommendations emphasize strengthening antenatal and postnatal care to address critical risk factors like anaemia, particularly prevalent in low- and lower-middle income countries. Anaemia significantly increases the risk of PPH and worsens outcomes when it occurs. The guidelines recommend daily oral iron and folate supplementation during pregnancy, with intravenous iron transfusions reserved for rapid correction when needed – including post-PPH or if oral therapy proves ineffective.
Beyond addressing underlying conditions, the guidelines advocate for safer birthing practices. Thay discourage routine episiotomies, promoting preventative measures like perineal massage in late pregnancy to reduce trauma and severe bleeding.
During the third stage of labor,the guidelines prioritize administering a quality-assured uterotonic to encourage uterine contraction,with oxytocin preferred and heat-stable carbetocin as an alternative. In settings where intravenous access is limited and the cold chain is unreliable, misoprostol is recommended as a last resort.
“Midwives know first-hand how quickly postpartum haemorrhage can escalate and cost lives,” stated Professor jacqueline Dunkley-Bent OBE, ICM’s Chief Midwife.”These guidelines are a game-changer. but to end preventable deaths from PPH, we need more then evidence and protocols. We call on governments, health systems, donors, and partners to step up, adopt these recommendations, adopt them quickly, and invest in midwives and maternal care so that postpartum haemorrhage becomes a tragedy of the past.”
To support implementation, the guidelines are accompanied by training and resources developed in partnership with UNFPA.these include practical modules for frontline health workers, national-level guides, and simulation-based training to improve emergency response capabilities.
A new study published concurrently in *The Lancet* by WHO and the UN Special Program on Human Reproduction (HRP) examined the diagnostic accuracy of indicators of serious postpartum bleeding, analyzing data from over 300,000 women across 23 countries. A related commentary on the guidelines was also published in *The Lancet Global Health*.
Funding for the guideline development was provided by the Gates Foundation.
