Introduction
This statement does not change the 2 previous statements on management
of the third stage of labor (both available at http://www.figo.
org/projects/prevent/pph): ICM/FIGO Joint Statement – Management
of the Third Stage of Labour to Prevent Post-partum Haemorrhage [1];
and ICM/FIGO Joint Statement – Prevention and Treatment of Postpartum
Haemorrhage: New Advances for Low Resource Settings [2].
The following guideline provides a comprehensive document regarding
best practice for the prevention and treatment of postpartum
hemorrhage (PPH) in low-resource settings.
FIGO is actively contributing to the global effort to reduce maternal
death and disability around the world. Its mission statement reflects a
commitment to the promotion of health, human rights, and wellbeing
of all women—especially those at greatest risk for death and disability
associated with childbearing. FIGO promotes evidence-based interventions
that, when applied with informed consent, can reduce the
incidence of maternal morbidity and mortality.
This statement reflects the best available evidence, drawn from scientific
literature and expert opinion, on the prevention and treatment
of PPH in low-resource settings.
Approximately 30% (in some countries, over 50%) of direct maternal
deaths worldwide are due to hemorrhage, mostly in the postpartum
period [3]. Most maternal deaths due to PPH occur in lowincome
countries in settings (both hospital and community) where
there are no birth attendants or where birth attendants lack the
necessary skills or equipment to prevent and manage PPH and
shock. The Millennium Development Goal of reducing the maternal
mortality ratio by 75% by 2015 will remain beyond our reach unless
we prioritize the prevention and treatment of PPH in low-resource
areas [4].
FIGO endorses international recommendations that emphasize the
provision of skilled birth attendants and improved obstetric services
as central to efforts to reduce maternal and neonatal mortality. Such
policies reflect what should be a basic right for every woman. Addressing
PPH will require a combination of approaches to expand access
to skilled care and, at the same time, extend life-saving interventions