Overview

• The guidance lowers the clinical action point from the traditional 500 mL to 300 mL of measured blood loss when abnormal vital signs are present to accelerate care.
• Clinicians are advised to use calibrated blood-collection drapes for objective monitoring immediately after birth to enable rapid diagnosis.
• Immediate management follows the MOTIVE bundle: uterine massage, oxytocic drugs, tranexamic acid, intravenous fluids, genital tract examination, and escalation if bleeding continues.
• Prevention recommendations include daily iron and folate in pregnancy, targeted intravenous iron when rapid correction is needed, quality-assured uterotonics in the third stage of labor—preferably oxytocin or heat-stable carbetocin—with misoprostol as a last resort, and discouraging routine episiotomy while promoting perineal massage.
• The package launches at the FIGO World Congress in Cape Town with UNFPA-supported training and implementation tools, as agencies urge rapid national adoption and investment in midwives to curb roughly 45,000 PPH deaths each year.