Perceptions Matter: Barriers to Treatment of Postpartum Hemorrhage


  • Sereen Thaddeus MA, MPH,

    Search for more papers by this author
    • At the time this article was written, Sereen Thaddeus was the Director of Behavior Change Communication on the Maternal and Neonatal Health Program, and Senior Program Officer at the Center for Communication Programs of the Johns Hopkins University Bloomberg School of Public Health. She has relocated to Kampala, Uganda as a Fellow at the USAID mission.

  • Rachna Nangalia MAIA,

    Search for more papers by this author
    • Rachna Nangalia was a Research Assistant on the Maternal and Neonatal Health Program, and a Program Assistant at the Center for Communication Programs.

  • Donna Vivio Deputy Director

    Corresponding authorSearch for more papers by this author

Maternal and Neonatal Health Program, 1615 Thames Street, Baltimore, MD 21231. E-mail:


Postpartum hemorrhage is the leading cause of maternal deaths in developing countries. This report highlights the social and cultural factors that influence the decision to seek care in cases of postpartum bleeding. Survey data on awareness of danger signs in the postpartum period and findings from the anthropologic literature describing beliefs about bleeding in childbirth and the postpartum period are presented. Findings point to a mismatch between actual and perceived risks of danger in the postpartum period. This may reflect a viewpoint that there are few risks remaining after the baby is born. This may, in turn, shape the perception that the postpartum period is one in which less vigilance is required compared with labor and birth. Such beliefs are important to consider, as they may influence timely seeking of emergency obstetric care. Efforts to reduce the incidence of postpartum hemorrhage as a major cause of maternal death must progress on two fronts: on the supply side to ensure the provision of skilled care and on the demand side to ensure that women and their families accept the view that bleeding after birth is dangerous and that skilled care is preferable to traditional care.