A landmark Lancet Series definitively estimates that excessive bleeding after birth affects 27 million women, kills nearly 43 000 women every year and costs countries, health systems and families globally over US$ 10 billion each year.

The Series, with lead researchers from HRP (the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction), the World Health Organization (WHO), and University of Oxford amplifies a fundamental shift in how postpartum haemorrhage (PPH), a leading cause of maternal deaths worldwide, should be detected and treated.

The Series highlights the importance of implementing the latest consolidated guidelines on the prevention, diagnosis and treatment of postpartum haemorrhage. Important new elements include treating postpartum haemorrhage as soon as 300 mL of blood is lost if accompanied by abnormal vital signs. The treatment protocol also includes measuring blood loss with a calibrated blood collection drape, disrupting an entrenched practice in maternity care of visually estimating blood loss. The Series concludes that visually estimating blood loss after birth is grossly inaccurate as it results in missing half of PPH cases.