Lack of fall in deaths due to postpartum haemorrhage a concern says RCM on new research

By RCM on 15 December 2016 BJOG - An International Journal of Obstetrics and Gynaecology Maternal Death Postnatal Care

New research published today in BJOG: An International Journal of Obstetrics and Gynaecology (BJOG) suggests that assisted reproductive technology (ART) could be associated with an increased risk of severe postpartum haemorrhage (PPH), in particular amongst multiple pregnancies.

Commenting on the research, Louise Silverton, Director for Midwifery at the Royal College of Midwives, said: “This research highlights why it is so important that midwives and other maternity staff receive the appropriate training to recognise and treat post partum haemorrhage, and that this training is refreshed regularly.

“While the numbers of women dying from this are small in the UK, the fact that there has been no real reduction in death rates due to postpartum haemorrhage is a concern.

“It also shows the need for greater continuity of care – that is the woman seeing the same midwife or small group of midwives. This will help midwives to spot developing problems because they will know the woman well and enable them to intervene early if problems do develop. Ideally, training should also include the whole maternity team so that if an emergency does occur, there are good systems in place and good communication between midwives, doctors and other health professionals.

“Midwives also need the time to advise women about normal blood loss after birth - amongst other signs and symptoms that they need to be aware of. This also includes what to do if they think the loss is more than expected, who to call and when. This is a concern for the RCM as our own research shows that many women are not getting the postnatal care they would like and midwives often have to limit postnatal care because of the demands on their time. * The level of postnatal care should always be based on clinical need not the limits imposed by demands on midwives time or the needs of the organisation they work for.”

“Units that do not have a protocol for this should endeavour to develop one as a matter of urgency.

“Women who may be at risk of postpartum haemorrhage should be made fully aware of any potential risk so that they can make an informed choice about where they want to give birth.”

To contact the RCM Press Office call 020 7312 3456 or email


Notes to editors

*See the RCM’s Pressure Points campaign. In a survey as part of the RCM’s postnatal Pressure Points campaign in 2014 the RCM asked midwives ‘What is the most significant factor influencing the decision about the number of postnatal visits a woman receives?’ 65% said this was influenced by organisational pressures not clinical need.  See the RCM’s Pressure Points campaign publications in the Publications section. 

The RCM is the only trade union and professional association dedicated to serving midwifery and the whole midwifery team. We provide workplace advice and support, professional and clinical guidance and information, and learning opportunities with our broad range of events, conferences and online resources. For more information visit the RCM website at