Postpartum hemorrhage (PPH), characterized by the loss of over 500 mL of blood within the first 24 hours post-delivery, is the primary cause of maternal fatalities globally. Each year, it impacts roughly 24 million women and leads to about 70,000 deaths, primarily in low- to middle-income nations, equating to one death every seven minutes. Now, a novel intervention, called E-MOTIVE, could represent a significant advancement in decreasing fatalities from postpartum bleeding, according to a pivotal study.

Researchers from the World Health Organization (WHO, Geneva, Switzerland) and the University of Birmingham (Edgbaston, UK) carried out a landmark study involving more than 200,000 women across four countries. Their findings indicated that accurately quantifying blood loss with an inexpensive, simple collection device known as a 'drape' and simultaneously administering WHO-endorsed treatments - as opposed to sequential delivery - led to significant improvements in outcomes for the women. Instances of severe bleeding – defined as a woman losing more than a liter of blood after delivery - were reduced by 60%, and the likelihood of death also decreased. Additionally, there was a significant decline in the rate of blood transfusions due to bleeding, which is particularly important in low-income nations where blood is a scarce and costly resource.

At present, one of the key hurdles in managing PPH is that it is often identified too late for effective response. The majority of healthcare providers rely on visual inspection to evaluate bleeding, which tends to underestimate blood loss and may result in life-threatening treatment delays. When treatment is administered, it is typically done sequentially, leading to time gaps between each intervention – wasting more time if the initial options are ineffective. The recommended E-MOTIVE approach includes early and precise detection of PPH using a blood-collection drape, supplemented by an immediate treatment bundle when needed. This bundle consists of uterine massage, medications to induce uterine contractions and halt the bleeding, intravenous fluid administration, an examination, and, if required, escalation to advanced care.

“This new approach to treating postpartum hemorrhage could radically improve women’s chances of surviving childbirth globally, helping them get the treatment they need when they need it,” said Professor Arri Coomarasamy, Co-Director of the WHO Collaborating Centre on Global Women’s Health at the University of Birmingham, who led the trial. “This new approach to treating postpartum hemorrhage could radically improve women’s chances of surviving childbirth globally, helping them get the treatment they need when they need it. Time is of the essence when responding to postpartum bleeding, so interventions that eliminate delays in diagnosis or treatment should be game changers for maternal health.” 

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