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.