Major primary postpartum haemorrhage
Primary postpartum haemorrhage (PPH) refers to heavy bleeding from the genital tract within 24 hours of the birth of a baby. PPH is considered major if there is a blood loss of more than 1,000mL. For more information, see Clinical commentary.
This indicator examines the proportion of women giving birth vaginally, and the proportion of women giving birth by caesarean section, who had major primary PPH of:
- more than or equal to 1,000mL but less than 1,500mL
- 1,500mL or more.
Key findings
Around 1 in 25 women giving birth vaginally (3.9%) and 1 in 23 women giving birth via caesarean section (4.4%) had a major primary PPH of more than or equal to 1,000mL but less than 1,500mL in 2023.
Around 1 in 42 women giving birth vaginally (2.4%) and 1 in 53 women giving birth via caesarean section (2.0%) had a major primary PPH of 1,500mL or more in 2023.
The proportions of women having a major primary PPH were:
often lowest for women living in areas of least disadvantage
- often highest for women living in Very remote areas and lowest for women living in Major cities.
The interactive data visualisation (Figure 16) presents data on major primary PPH. Use the drop-down menus to view data by selected characteristics and the latest year button to explore data for 2023.
Figure 16: Major primary postpartum haemorrhage
This data visualisation presents data on major primary PPH. Interactive charts show proportions for the most recent data and over time, for selected demographic and birth characteristics.
Clinical commentary
PPH is a major cause of maternal mortality and morbidity in Australia, and is a leading cause of maternal death globally. PPH can be classified into primary (within 24 hours of birth) and secondary (between 24 hours and six weeks postpartum) (RANZCOG 2021c; Safer Care Victoria 2018).
The most common cause of primary PPH is uterine atony, or the inability of the uterus to contract properly following birth. Other causes of PPH include bleeding due to injury of the genital tract, and bleeding related to retained placental tissue or blood clots, which can also contribute to uterine atony (SA Health 2024).
The majority of women who have PPH will have no identified risk factors. However, there are factors that are associated with a higher risk of having PPH, such as multiple pregnancy, prolonged labour, hypertensive disorders such as pre-eclampsia, and blood disorders (Mavrides et al. 2016; Safer Care Victoria 2018).
It is widely recommended that drugs to improve uterine muscle tone be administered in the period following birth, prior to the delivery of the placenta, to reduce the risk of PPH (NSW Health 2025; SA Health 2024; WHO 2012). Treatments for PPH may include medications, administration of blood products and fluids, and surgical interventions (RANZCOG 2021c; SA Health 2024; Safer Care Victoria 2018).
Indicator specifications and data
Excel source data tables are available from Data.
For more information, refer to Data specifications and Methods.
Mavrides E, Allard S, Chandraharan E, Collins P, Green L, Hunt BJ, Riris S and Thomson AJ (2016) ‘Prevention and management of postpartum haemorrhage’, BJOG, 124:e106–e149, doi:10.1111/1471-0528.14178.
NSW Health (2025) ‘Postpartum Haemorrhage (PPH)’, NSW Health, NSW Government, accessed 11 September 2025.
RANZCOG (2021c) ‘Management of Postpartum Haemorrhage (C-Obs 43)’, RANZCOG, accessed 30 May 2024.
Safer Care Victoria (2018) Postpartum haemorrhage (PPH) – prevention, assessment and management, Safer Care Victoria, Victorian Government, accessed 30 May 2024.
SA Health (2024) ‘Postpartum Haemorrhage (PPH)’, SA Health, Government of South Australia, accessed 30 May 2024.
WHO (2012) ‘WHO recommendations for the prevention and treatment of postpartum haemorrhage’, WHO, accessed 30 May 2024.