Consolidated guidelines for the prevention, diagnosis and treatment of postpartum haemorrhage — synopsis and framework.
Postpartum haemorrhage is one of the most common complications of childbirth and accounts for nearly one fifth of all maternal deaths worldwide — and the leading cause of maternal death in most low-income countries. Most of these deaths are preventable with timely, effective care.
This is the first edition of WHO's consolidated PPH guidelines and a direct response to the Roadmap to combat postpartum haemorrhage (2023–2030). It brings together 51 recommendations spanning antenatal, intrapartum and postpartum care, diagnosis, first-response and refractory treatment, supportive care, and health-system interventions — replacing fragmented, sometimes contradictory guidance with a single evidence-based foundation. Recommendations were developed using the GRADE evidence-to-decision approach by an international Guideline Development Group across meetings in 2024–2025; 20 are new or updated and 31 are integrated from existing WHO guidelines.
For the first time, WHO co-published maternal-health guidelines with the International Federation of Gynecology and Obstetrics (FIGO) and the International Confederation of Midwives (ICM), signalling a more interdisciplinary approach to translating global evidence into national practice. The work supports Sustainable Development Goal target 3.1 — reducing the global maternal mortality ratio to fewer than 70 per 100,000 live births by 2030.
A summary of WHO Fig. 1.1 — risk factors and contributors mapped across the continuum, the pathway to morbidity and mortality, and where interventions act.
The four intervention stages map to this navigator's care contexts. Source: WHO 2025, Fig. 1.1.
47 high-level recommendations (51 individually actionable, including sub-recommendations 7.1–7.3 and 9.1–9.3) across the care continuum. 20 new or updated in 2024–2025; 31 integrated from prior WHO guidelines.
How the 51 recommendations break down, and the evidence behind the new diagnostic threshold.
Bars show the 47 high-level recommendations. Counted at the 51 individually-actionable level (with sub-recommendations 7.1–7.3 and 9.1–9.3), WHO reports 20 new or updated in 2024–2025 and 31 integrated (revalidated or edited) from existing WHO guidelines.
Recommendation 22 lowers the action threshold below the conventional 500 mL. It is based on a WHO individual-participant-data meta-analysis of over 300,000 women from 12 datasets across 23 countries (moderate-certainty evidence).
| Trigger criterion | Purpose |
|---|---|
| Blood loss ≥300 mL + any abnormal haemodynamic sign | Earlier, more sensitive detection of women at risk of severe outcomes |
| Blood loss ≥500 mL (alone) | Catches heavy bleeding regardless of vital signs |
| Whichever occurs first, within 24 h | Trigger first-response bundle & referral — not advanced therapy by itself |
Abnormal haemodynamic signs: pulse >100 bpm · shock index >1 (pulse ÷ SBP) · systolic BP <100 mmHg · diastolic BP <60 mmHg. Source: Gallos et al. Lancet 2025; WHO 2025.
Vancouver format. Every threshold, dose and recommendation in this tool traces directly to these sources.
DOIs displayed are reproduced from the WHO 2025 reference list. Verify against PubMed/CrossRef before citing in a manuscript.