Abstract
BACKGROUND: Postpartum haemorrhage (PPH) is a preventable yet leading cause of maternal death, demanding urgent attention and action. Every year, tens of thousands of women die from postpartum haemorrhage a tragedy that is both preventable and unacceptable. Each maternal death represents a systemic failure. This umbrella review consolidates global evidence on burden, disparities, and determinants of postpartum haemorrhage (PPH) to inform policymaker's evidence decision making. METHODS: A comprehensive literature search was conducted between July 30 and August 15, 2025, across PubMed, Scopus, Science Direct, Web of Science, Cochrane, and related review databases to identify systematic reviews and meta-analyses on the prevalence, disparities, and determinants of postpartum haemorrhage among women who gave birth. Study quality was assessed using the AMSTAR tool. Heterogeneity was examined with Cochran's Q and I², publication bias via Egger's test and funnel plots, and pooled effect sizes estimated through random-effects meta-analysis using Stata 19. The review protocol was registered in PROSPERO (CRD420251121022). RESULT: This umbrella review included 17 systematic reviews with sample size of over 21 million women to estimate the global pooled prevalence of postpartum haemorrhage (PPH) at 9.97% (95% CI: 6.90%-13.04%), with (p < 0.001). Based on studies using objective blood loss measurement (≥500 mL per 100 women giving birth), the prevalence increased to 11.25% (95% CI: 8.78%-13.72%) with p < 0.001.Globally pooled prevalence of severe postpartum haemorrhage is estimated at 4.52% (95% CI: 2.47%-6.57%) with p < 0.001, indicating that nearly 1 in 20 women experience life-threatening bleeding after childbirth.This study identified key risk factors for postpartum haemorrhage, including maternal age, lack of antenatal care, obstetric complications, and rural residence. These determinants highlight the need for targeted prevention strategies to reduce PPH-related morbidity and improve maternal health outcomes. CONCLUSION AND RECOMMENDATION: The study underscores postpartum haemorrhage (PPH) as a critical global health issue, with approximately 1 in 10 women experiencing PPH worldwide and 1 in 20 affected by severe PPH, highlighting the urgent need to address persistent disparities. An immediate policy action is essential to guarantee timely, effective care and to uphold maternal health as a fundamental human right. As the global call reminds us: "No woman should die giving life." SYSTEMATIC REVIEW REGISTRATION: [https://www.crd.york.ac.uk/PROSPERO/view/CRD420251121022], identifier CRD420251121022.