More than half a millon women die each year in childbirth, mostly in developing
countries. Severe bleeding in the postpartum period is the single most important
cause of maternal deaths worldwide. More than half of all maternal deaths occur
within 24 hours of delivery, most commonly from excessive blood loss. Postpartum
haemorrhage also causes serious morbidity in many women and contributes to
maternal mortality in part due to poor maternal health status and also to the lack of
adequately equipped delivery facilities and inappropriate management of the third
stage of labour.
Key messages
􀃎 Postpartum haemorrhage is the most common cause of maternal death in lowand
middle-income countries.
􀃎 Active management of the third stage of labour is associated with a lower
incidence of postpartum haemorrhage, less blood loss and reduced risk of blood
transfusion.
􀃎 When ergot preparations are used -as part of active management- there are an
increase of the risk of nausea, vomiting and raised blood pressure.