In February 2026, Sunita Bai, a 24-year-old woman, delivered a healthy baby girl weighing under 3 kg (6.6 pounds) at the Vidisha District Hospital in Madhya Pradesh, India. For her and her family, it was a moment of immense joy after months of anticipation.
Within minutes of delivery, the nursing team noticed that she was bleeding more than expected. Instead of relying on a visual assessment of blood loss, they placed a calibrated blood collection drape underneath her, as is routinely done for each vaginal birth. This drape measures postpartum blood loss objectively and efficiently and was introduced through the Unitaid-funded Accelerating Measurable Progress and Leveraging Investments for Postpartum Hemorrhage Impact (AMPLI-PPHI) project. Within 15 minutes after the placental delivery, the drape measured approximately 550 mL of blood loss. Given that blood loss after vaginal childbirth of 300 mL or more, accompanied by any hemodynamic warning signs (i.e., low blood pressure), or blood loss more than 500 mL is diagnosed as postpartum hemorrhage (PPH), the team promptly recognized the dire situation and that immediate action was required to save Sunita’s life.
Recognizing this situation early, Nursing Officer In-Charge, Shashi Baghel, and Nursing Officer, Anjani Umre, promptly initiated the clinical treatment bundle (MOTIVE) for the management of PPH, which includes massage of the uterus, oxytocics drug administration, tranexamic acid, intravenous fluids, and examination and monitoring of Sunita’s condition in accordance with the state government’s PPH management protocol.
As a part of the AMPLI-PPHI project, 29 nursing officers and eight doctors at the Vidisha District Hospital received competency-based training that included preventive measures for PPH with oxytocics such as heat-stable carbetocin or oxytocin during active management of the third stage of labor; early identification using calibrated blood collection drapes; adoption of the MOTIVE bundle approach for PPH management; treatment protocols for refractory PPH (simulation-based); and team communication.
"Before receiving the (AMPLI PPHI) training, managing PPH was often difficult. We were less confident in handling such obstetric emergencies. But after the training and regular practice using calibrated blood collection drapes and standard PPH protocols, we feel much more confident in identifying excessive bleeding early and responding quickly. This has strengthened our ability to save mothers' lives." —Shashi Baghel, Nursing Officer In-Charge, District Hospital, Vidisha
As a result of these interventions, Vidisha District’s PPH incidence rate decreased by 40.3%; the rate dropped from 1.34% in March 2024 to 0.80% in June 2026.
The nursing team applied the skills and knowledge gained through this training, initiated the MOTIVE bundle without delay, and continued to closely monitor Sunita’s condition.
Following the treatment, the bleeding was brought under control, and Sunita recovered without any further complications. What could have been a frightening experience for the family ended with both mother and baby safe and healthy. For the nursing team, the incident reinforced the value of being prepared and acting quickly, as a team, when it mattered most.
Their experience is a reminder that improving maternal health care is not only about introducing new equipment or clinical guidelines. It is equally about ensuring that health care providers can build their skills, practice regularly, and feel confident in making critical decisions during emergencies.
The experience from Vidisha shows how clinical capacity strengthening, coupled with new PPH products, is translating into better care for mothers, helping frontline providers respond swiftly, manage complications effectively, and ensure that more women return home safely with their newborns.
Shiv Pratap Singh is a program coordinator for Jhpiego in India.
The Accelerating Measurable Progress and Leveraging Investments for Postpartum Hemorrhage Impact (AMPLI-PPHI) (pronounced “amplify”) project works with countries to accelerate short- and long-term action to prevent and treat PPH, focusing on three key areas: generating evidence and project learning, creating an enabling environment, and improving the market for the adoption of key lifesaving tools.
