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Women’s health and midwifery
Recent data indicate that black women are at greater risk of severe morbidity and mortality from postpartum haemorrhage, both before and after adjusting for comorbidity.
  1. Christine J Caldwell,
  2. Lynn McCullagh
  1. Department of Adult Nursing and Midwifery Studies, School of Health and Social Care, London South Bank University, London, UK
  1. Correspondence to Christine J Caldwell, School of Health and Social Care/Department of Adult Nursing, London South Bank University, London SE1 0AA, UK; caldwecj{at}

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Commentary on: Gyamfi-Bannerman C, Srinivas SK, Wright JD, et al. Postpartum haemorrhage outcomes and race. Am J Obstet Gynaecol 2018;219:185.e1-185.e10.

Implications for practice and research

  • Causes of increased risk of severe morbidity and mortality related to postpartum haemorrhage in black women in the USA are poorly understood and warrant further research.

  • There is a need for tailored maternity services and improved access to care for women from ethnic minorities.


Obstetric haemorrhage is the leading cause of obstetric death worldwide, and postpartum haemorrhage (PPH) accounts for ~75% of these.1 Most cases of PPH can be successfully managed if diagnosed early, but this is dependent on the availability of adequate knowledge, skills and resources.

Previous studies have shown some variability in the mortality/morbidity rates relating …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.