WHO, FIGO, ICM have issued new guidance
https://www.who.int/news/item/05-10-2025-global-health-agencies-issue-ne...
Extracts and a comment from me below.
EXTRACTS
Through landmark new guidelines released today, leading reproductive health agencies are calling for a major shift in how postpartum haemorrhage (PPH) is prevented, diagnosed and treated. The recommendations highlight the urgent need for earlier detection and faster intervention – steps that could save the lives of tens of thousands of women each year.
Defined as excessive bleeding after childbirth, PPH affects millions of women annually and causes nearly 45 000 deaths, making it one of the leading causes of maternal mortality globally. Even when not fatal, it can lead to lifelong physical and mental health impacts, from major organ damage to hysterectomies, anxiety and trauma.
“Postpartum haemorrhage is the most dangerous childbirth complication since it can escalate with such alarming speed. While it is not always predictable, deaths are preventable with the right care,” said Dr Jeremy Farrar, Assistant Director-General for Health Promotion and Disease Prevention and Care. “These guidelines are designed to maximize impact where the burden is highest and resources are most limited – helping ensure more women survive childbirth and can return home safely to their families.”...
The guidelines recommend the immediate deployment of the MOTIVE bundle of actions once PPH has been diagnosed. This includes:
Massage of the uterus;
Oxytocic drugs to stimulate contractions;
Tranexamic acid (TXA) to reduce bleeding;
Intravenous fluids;
Vaginal and genital tract examination; and
Escalation of care if bleeding persists.
In rare cases where bleeding continues, the guidelines recommend effective interventions such as surgery or blood transfusion to safely stabilize a woman’s condition until further treatment becomes available.
COMMENT (NPW): It's curious that the guidelines do not even mention the FOCUS approach described to us by HIFA member Frank Jackson (United States> 'FOCUS (Foley Catheter for Uterine Suction) is a non-commercial, off-label technique that repurposes a standard Foley catheter connected to gentle suction to control hemorrhage through vacuum-induced uterine tamponade. It mimics the physiologic mechanism of uterine contraction, similar to commercial devices like the JADA system, but with equipment already available in nearly every delivery room or emergency setting'. Is this because the Foley catheter approach has not yet provied its effectiveness? I have invited Frank to comment.
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org