New Guidelines for the Prevention, Diagnosis, and Treatment of Postpartum Haemorrhage Emerge

Author: Azuka Chinweokwu Ezeike, MBBS, FWACS, FMCOG, MSc (PH)

On October 5, 2025, the World Health Organization (WHO), in collaboration with the International Federation of Gynecology and Obstetrics (FIGO) and the International Confederation of Midwives (ICM), released the Consolidated Guidelines for the Prevention, Diagnosis, and Treatment of Postpartum Haemorrhage (PPH).

This is the first time these three leading global organisations have come together to develop a single comprehensive guideline on postpartum haemorrhage.The launch also marked the official declaration of October 5 as World Postpartum Haemorrhage Day. The event took place during the FIGO World Congress in Cape Town, South Africa.

The guidelines build on the Roadmap to Combat Postpartum Haemorrhage (2023–2030), which calls for evidence-based approaches to reduce maternal deaths from excessive bleeding after childbirth.

Why the Guideline Matters

Postpartum haemorrhage (excessive bleeding after childbirth remains the leading cause of maternal death globally, especially in low-resource settings. 

The new guideline provides a unified, evidence-based approach to prevention, diagnosis, and management across the antenatal, intrapartum, and postnatal periods.

Key Highlights of the New Guidelines

The document contains 51 recommendations covering prevention, diagnosis, treatment, supportive care, and health system interventions for PPH.

1. Updated Definition:
 The guideline now defines clinically significant postpartum haemorrhage as blood loss of 300 mL or more with signs of low blood volume (such as low blood pressure or rapid pulse), or 500 mL of blood loss, whichever comes first. This change helps health workers detect and act earlier.

2. Preventive Measures:
 The guideline recommends oxytocin, heat-stable carbetocin, or misoprostol for prevention after childbirth.

• Intravenous oxytocin remains the preferred choice.
  
  
• Heat-stable carbetocin is advised when the cold chain for oxytocin cannot be maintained.
  
  
• Misoprostol is recommended when neither of the above is available.

3. The MOTIVE Bundle for Treatment:
 The guideline validates the MOTIVE bundle, a structured approach to the rapid management of PPH:

• M: Immediate uterine massage
  
  
• O: Administration of an oxytocic agent
  
  
• T: Administration of tranexamic acid
  
  
• IV: Intravenous fluids
  
  
• E: Examination of the genital tract and escalation of care
  
  

This bundle encourages timely, coordinated action to save lives.

Implementation and Next Steps

For the guidelines to make a real difference, there must be:

• Proper dissemination and training of health workers
  
  
• Regular supervision and mentoring at all levels
  
  
• Functional supply chains to ensure drug and equipment availability
  
  
• Monitoring systems at facility, subnational, and national levels using locally adapted indicators
  
  

If properly implemented, these guidelines could significantly reduce deaths from postpartum haemorrhage and strengthen maternal care systems worldwide.

Sources

1. Consolidated guidelines for the prevention, diagnosis and treatment of postpartum haemorrhage. Geneva: World Health Organization; 2025. Licence: CC BY-NC-SA 3.0 IGO. Available from: https://iris.who.int/server/api/corebitstreams/88bf11a5-93b6-4d6b-bdaa-856b46c8ed3c/content
2.  World PPH Day: A New Collective Call to End Preventable Maternal Deaths. Available from: https://internationalmidwives.org/world-pph-day-to-end-preventable-maternal-deaths/

Disclaimer:
The information provided on this website is for general educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Published October 16, 2025