SYSTEMATIC REVIEW article
Front. Reprod. Health
Sec. Reproductive Epidemiology
Global burden, disparities, and determinants of postpartum haemorrhage among women who gave birth: An umbrella review of systematic reviews and meta-analyses
Provisionally accepted
- 1Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa
- 2University of Cape Town Faculty of Health Sciences, Cape Town, South Africa
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Background: Postpartum haemorrhage (PPH) is a preventable yet leading cause of maternal death, demanding urgent attention and action. Every year, tens of thousands of women die from postpartum haemorrhage a tragedy that is both preventable and unacceptable. Each maternal death represents a systemic failure. This umbrella review consolidates global evidence on burden, disparities, and determinants of postpartum haemorrhage (PPH) to inform policymaker's evidence decision making. Methods: A comprehensive literature search was conducted between July 30 and August 15, 2025, across PubMed, Scopus, Science Direct, Web of Science, Cochrane, and related review databases to identify systematic reviews and meta-analyses on the prevalence, disparities, and determinants of postpartum haemorrhage among women who gave birth. Study quality was assessed using the AMSTAR tool. Heterogeneity was examined with Cochran's Q and I², publication bias via Egger's test and funnel plots, and pooled effect sizes estimated through random-effects meta-analysis using Stata 19. The review protocol was registered in PROSPERO (CRD420251121022). Result: This umbrella review included 17 systematic reviews with sample size of over 21 million women to estimate the global pooled prevalence of postpartum haemorrhage (PPH) at 9.97% (95% CI: 6.90–13.04%), with (p < 0.001). Based on studies using objective blood loss measurement (≥500 mL per 100 women giving birth), the prevalence increased to 11.25% (95% CI: 8.78–13.72%) with p < 0.001. 2 | P a g e Globally pooled prevalence of severe postpartum haemorrhage is estimated at 4.52% (95% CI: 2.47–6.57%) with p < 0.001, indicating that nearly 1 in 20 women experience life-threatening bleeding after childbirth. This study identified key risk factors for postpartum haemorrhage, including maternal age, lack of antenatal care, obstetric complications, and rural residence. Conclusion and Recommendation: The study underscores postpartum haemorrhage (PPH) as a critical global health issue, with approximately 1 in 10 women experiencing PPH worldwide and 1 in 20 affected by severe PPH, highlighting the urgent need to address persistent disparities. An immediate policy action is essential to guarantee timely, effective care and to uphold maternal health as a fundamental human right. As the global call reminds us: "No woman should die giving life."
Keywords: Global prevalence, Health Disparities, Maternal health, Postpartum haemorrhage (PPH), Risk factors, Systematic reviews, Umbrella review
Received: 09 Oct 2025; Accepted: 05 Dec 2025.
Copyright: © 2025 Demissie, Kaura and Gebhardt. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dereje Bayissa Demissie
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