Targeting PPH across the system
Most clinical work to tackle PPH happens ‘downstream’ – after the baby is born. The bulk of work to tackle PPH involves non-clinical teams and organisations putting in place the right conditions ‘upstream’, to ensure:
· that PPH is detected early enough
· that the right treatments are available
· that staff have the awareness, skills and tools they need to do the job.
Figure 1 sets out the actions that need to happen upstream. They are carried out by individual organisations, wider health systems and governments, so that when a woman has PPH everything is in place for an immediate, effective response.
Clinicians do have a role to play upstream, too, by proactively identifying women at high risk of PPH (especially those with anemia) and giving them treatment and a birth plan that reduces the risks to mother and baby, as far as possible.