Postpartum Hemorrhage Kills 43,000 Women a Year — and 95% of Deaths Are Preventable

Every year, 43,000 women die from excessive bleeding after childbirth. The condition that kills them — postpartum hemorrhage — affects an estimated 27 million women annually. And according to a landmark three-part series published on June 12, 2026 in The Lancet, the vast majority of those deaths should not be happening.

The series was co-authored by Dr. Olufemi Oladapo, a physician with the World Health Organization's Special Programme on Human Reproduction, alongside researchers from the University of Oxford, the WHO Maternal and Perinatal Health Unit, and institutions across four continents. Their conclusion is direct: "If we use what we have now, we will reduce more than 95% of the deaths," Oladapo told NPR.

The series is the most comprehensive global review of postpartum hemorrhage ever published, covering prevention, diagnosis, treatment, and health system reform — and it lands at a moment when maternal mortality from this single cause remains stubbornly high in low-resource countries despite being nearly eliminated in wealthy ones.

A 200-Times Gap Between Rich and Poor Countries

The headline finding of the Lancet series is a disparity so wide it is difficult to fully process.

The mortality rate from postpartum hemorrhage is more than 200 times higher in under-resourced countries — including Afghanistan, Vietnam, and Nigeria — than in well-resourced countries like the United States, according to NPR.

The underlying cause of that gap is not how often postpartum hemorrhage occurs. As Oladapo told NPR: "The rate of postpartum hemorrhage is not any different between high-income countries and low-income countries. What is different is what is given when these conditions are identified."

The condition itself does not discriminate by geography. The response to it does.

A woman who delivers without complication can deteriorate within 10 to 20 minutes if excessive bleeding is not recognised and treated. "It can become a medical emergency very quickly," said Adam Devall, a professor of maternal health at the University of Oxford and one of the series co-authors, per NPR. "Typically the women say, 'I feel like I'm dying.' They actually sense it when they are bleeding too much," added Ioannis Gallos, of the WHO's Maternal and Perinatal Health Unit.

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The Diagnostic Problem — and a Simple Fix

One of the most striking findings in the series is how often the condition is simply missed.

According to the series published directly in The Lancet01031-7/abstract), a systematic review found that subjective visual estimation of blood loss misses 52% of postpartum hemorrhage diagnoses at vaginal birth — meaning more than half of cases are not identified when healthcare workers rely on eyeballing rather than measuring.

The solution identified is low-tech and inexpensive: a calibrated blood collection drape placed beneath the woman during delivery that gives midwives and doctors a measurable, objective reading of blood loss. "These lines allow midwives and doctors to easily see the amount of blood loss after the birth," the series notes, per KPBS/NPR.

The gap between what is known and what is practised is not a knowledge problem — it is a systems and supply problem. The calibrated drape exists. The evidence behind it is robust. The challenge is getting it into every delivery room worldwide.

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Treatment — What Works and Where the Gaps Are

The Lancet series outlines a structured treatment pathway that already exists and already works where it is applied.

Oxytocin is the first-line drug for both preventing and treating postpartum hemorrhage — given intramuscularly or intravenously at 10 IU. It is highly effective but requires refrigeration, which is a logistical barrier in low-resource settings with unreliable cold chains. For those settings, the series recommends heat-stable carbetocin as an alternative, and misoprostol — an oral or sublingual tablet requiring no refrigeration — where injections or cold chain are not feasible.

Tranexamic acid, an inexpensive drug that reduces bleeding by inhibiting clot breakdown, is recommended as part of the treatment package alongside intravenous fluids and access to a functioning blood transfusion system.

According to The Lancet Global Health00404-8/fulltext), the series also calls for community and lay administration of misoprostol to be formally licensed in settings where births frequently occur outside health facilities — a regulatory change that could extend the reach of treatment to the most remote births.

Beyond drugs, the series calls for "pit-crew-like" simulation-based training for entire care teams — not just individual practitioners — so that when hemorrhage begins, every member of the team responds simultaneously rather than sequentially, per KPBS.

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The Economic Case for Action

One of the series' sharpest arguments is a financial one.

"Postpartum hemorrhage as it is now is costing us more money than what we would have used to prevent it," Oladapo told NPR. "If you invest even 5% of the cost of postpartum hemorrhage in preventing it, you're going to not just save lives but also save money."

That framing — positioning prevention not as a humanitarian expenditure but as a cost-saving intervention — is deliberate. It addresses the reality that health ministries in low-resource countries are making budget decisions under extreme pressure, and arguments built purely on moral obligation have historically failed to shift resource allocation at scale.

Dr. Tarun Sanghvi, one of the series contributors, expressed confidence in the timeline: "This is the decade in which we can probably reach the goal of eliminating postpartum hemorrhage as the leading cause of maternal death. I think it is within our reach."

Doreen Kainyu Kaura, a professor of midwifery at the University of the Western Cape in South Africa who was not involved in the research, reviewed the conclusions and told NPR they aligned with what she has observed in delivery rooms across the continent: "Women should not be dying from PPH in this day and age, given what we know."

Key Takeaways

• A three-part Lancet series published June 12, 2026 identifies postpartum hemorrhage as killing 43,000 women annually — and concludes 95% of those deaths are preventable with existing tools.
• PPH affects 27 million women per year. The mortality gap between high and low-resource countries exceeds 200 times.
• A simple calibrated blood collection drape could eliminate the 52% diagnostic miss rate from visual estimation.
• First-line treatment: oxytocin; alternatives include heat-stable carbetocin and misoprostol for cold-chain-limited settings, plus tranexamic acid.
• The series calls for pit-crew simulation training, regulatory reform to permit community misoprostol administration, and a functional blood transfusion system at every birth facility.
• Lead author Dr. Oladapo: "If we use what we have now, we will reduce more than 95% of the deaths."

Sources

• NPR — What would it take to stop women from bleeding to death after childbirth?
• KPBS / NPR — What would it take to stop women from bleeding to death after childbirth?
• The Lancet — Diagnosis and treatment of postpartum haemorrhage: a race against time
• The Lancet Global Health — New guidelines for the prevention, diagnosis, and treatment of postpartum haemorrhage

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