A major step forward in protecting mothers and saving lives
Every year, millions of women around the world face one of the most dangerous childbirth complications — postpartum haemorrhage (PPH), or severe bleeding after giving birth. This condition claims nearly 45,000 lives annually, making it the leading cause of maternal death worldwide. But new international guidelines released on October 5, 2025, by the World Health Organization (WHO), the International Federation of Gynecology and Obstetrics (FIGO), and the International Confederation of Midwives (ICM) could mark a turning point in how the world prevents and responds to this crisis.
🚨 A Call for Faster Action and Smarter Prevention
The new guidelines, launched during the 2025 FIGO World Congress in Cape Town, introduce a transformational approach to PPH management — focusing on early detection, rapid treatment, and effective prevention.
Traditionally, doctors diagnosed PPH when a woman lost 500 mL of blood or more after childbirth. However, the new recommendations urge healthcare workers to act earlier — at 300 mL of blood loss or whenever abnormal vital signs are observed.
To ensure accurate diagnosis, WHO now recommends the use of calibrated drapes, simple tools that collect and measure blood loss directly after delivery. This change enables faster, evidence-based decision-making that can save lives in minutes.
💊 The MOTIVE Bundle: A Life-Saving Protocol
Once PPH is diagnosed, health workers are urged to immediately perform the MOTIVE bundle of actions, a structured approach proven to stop bleeding and stabilize patients:
- Massage the uterus to stimulate contractions
- Oxytocic drugs to help the uterus contract
- Tranexamic acid (TXA) to reduce bleeding
- Intravenous fluids to replace lost blood volume
- Vaginal and genital examination for tears or retained tissue
- Escalation of care if bleeding continues
In cases where bleeding persists, surgery or blood transfusion may be necessary to stabilize the mother until further treatment is available.
🌿 Preventing Postpartum Haemorrhage Before It Starts
Prevention remains key. The guidelines emphasize treating anaemia during pregnancy — a major risk factor for PPH — through daily iron and folate supplements or intravenous iron when rapid correction is needed.
They also discourage unnecessary episiotomies (cuts during childbirth) and instead promote safer alternatives like perineal massage in late pregnancy to reduce trauma and bleeding.
During the final stage of labour, health providers are advised to administer a quality uterotonic, preferably oxytocin or heat-stable carbetocin, to help the uterus contract. In settings where refrigeration is limited, misoprostol may be used as a reliable alternative.
🧡 Empowering Midwives and Health Systems
Midwives are at the heart of this life-saving effort. Professor Jacqueline Dunkley-Bent, ICM’s Chief Midwife, emphasized:
“To end preventable deaths from PPH, we need more than evidence and protocols — we need governments and health systems to act now and invest in maternal care.”
The guidelines come with training modules, national guides, and simulation-based learning tools, designed to help frontline workers in all countries adopt these changes quickly and effectively.
🌎 A Global Commitment to Saving Mothers
The publication is part of the Global Roadmap to Combat Postpartum Haemorrhage (2023–2030) — a global effort to make maternal death from PPH a tragedy of the past.
With better readiness, recognition, and response, experts believe that thousands of lives can be saved every year — especially in low-resource settings, where most maternal deaths occur.
As WHO’s Dr. Jeremy Farrar put it:
“Postpartum haemorrhage is not always predictable, but deaths are preventable with the right care.”