• Gani N Gani
  • Ali TS Ali


Background: Postpartum haemorrhage (PPH) is one of the main causes of maternal mortality globally. The objective of this study was to estimate the prevalence of PPH and identify factors associated with PPH in Khyber Agency, Pakistan. Methodology: A quantitative, cross-sectional study design was selected to estimate the prevalence and associated factors for PPH among married women aged 15–49 years, residing in the Khyber Agency, FATA, Pakistan. A pre-tested structured questionnaire was adapted with some modifications to interview 1,000 women. Results: Prevalence of PPH was 21.3% in the study population. Factors associated with PPH were age, number of pregnancies, duration of labour, avoidance of milk, insertion of homemade remedies in vagina, retained placenta, and rest during postpartum period. Conclusion: Poor infrastructure, lack of appropriate training for healthcare providers, economic conditions, and negative cultural practices are some amongst the multiple factors that have a perilous impact on women’s health, particularly women of reproductive age. The morbidities were the result of malpractices ingrained in the community.Keywords: Postpartum Haemorrhage, Maternal Mortality, Morbidity, Postpartum, Malpractices


Zuberi NF, Durocher J, Sikander R, Baber N, Blum J, Walraven G. Misoprostol in addition to routine treatment of postpartum hemorrhage: a hospital-based randomized-controlled trial in Karachi, Pakistan. BMC Pregnancy and Childbirth 2008;8(1):40.

Bibi S, Danish N, Fawad A, Jamil M. An audit of primary post partum haemorrhage. J Ayub Med Coll Abbottabad 2007;19:102–6.

WHO, UNICEF, & UNFPA. Maternal mortality in 2000: Geneva.

Fikree FF. Reproductive health in Pakistan: evidence and future directions. Reproductive Health. 2002.

Hoestermann CF, Ogbaselassie G, Wacker J, Bastert G. Maternal mortality in the main referral hospital in The Gambia, West Africa. Trop Med Int Health 1996;1(5):710–7.

Ramakrishna J, Ganapathy S, Mahendra S. After Birth: Bananthana in rural Karnataka. Proceedings of Reproductive Health in India: New Evidence and Issues Ministry of Health and Population. 2000.

Mustafa R, Hashmi H. Near-miss obstetrical events and maternal deaths. J Coll Physicians Surg Pak 2009;19(12):781–5.

Naz H, Sarwar I, Fawad A, Nisa AU. Maternal morbidity and mortality due to primary PPH —experience at Ayub Teaching Hospital Abbottabad. J Ayub Med Coll Abbottabad 2008;20(2):59–65.

Rizwan N, Abbasi RM, Jatoi N. Retained placenta still a continuing cause of maternal morbidity and mortality. J Pak Med Assoc 2009;59(12):812–4.

Ali T. Prevalence and factors associated with morbidities among married mothers during postpartum period in squatter settlements of Karachi. Unpublished dissertation 2006. Karachi: Aga Khan University.

Ali TS, Fikree FF, Rahbar MH, Mahmud S. Frequency and determinants of vaginal infection in postpartum period: a cross-sectional survey from low socioeconomic settlements, Karachi, Pakistan. J Pak Med Association 2006;56(3):99.

Hassan TJ, Baqai R, Jafarey SN, Alam SE. Maternal morbidity in the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre Karachi. J Pak Med Association 1991;41(9):223.

Fikree FF, Ali TS, Durocher JM, Rahbar MH. Newborn care practices in low socioeconomic settlements of Karachi, Pakistan. Soc Sci Med 2005;60(5):911–21.

Ayello EA, Thomas DR, Litchford MA. Nutritional aspects of wound healing. Home Healthc Nurse 1999;17(11):719–29.

Beckmann N, Schuler A, Mueggler T, Meyer EP, Wiederhold K-H, Staufenbiel M, et al. Age-dependent cerebrovascular abnormalities and blood flow disturbances in APP23 mice modeling Alzheimer’s disease. J Neurosci 2003;23(24):8453–9.

Brisson G, Singh H. Milk composition, physical and processing characteristics. Manufacturing Yogurt and Fermented Milks 2013:21–48.

Ghani N, Rukanuddin RJ, Ali TS. Prevalence and factors associated with postpartum vaginal infection in the Khyber Agency, Federally Administered Tribal Areas, Pakistan. J Pak Med Assoc 2007;57(7):363–7.

Rhoton-Vlasak A. Infections and infertility. Prim Care Update Ob Gyns 2000;7(5):200–6.

Feerasta SH, Motiei A, Motiwala S, Zuberi NF. Uterine atony at a tertiary care hospital in Pakistan: a risk factor analysis. J Pak Med Assoc 2000;50(4):132–6.

Naib JM, Siddiuqi MI, Jehangir S. The role of prostaglandins in the management of primary post partum haemorrhage due to uterine atony/hypotony and the impact of their use on the need for obstetrical hysterectomy. J Postgrad Med Inst 2004;18(2):293–9.

Magann EF, Evans S, Hutchinson M, Collins R, Howard BC, Morrison JC. Postpartum hemorrhage after vaginal birth: an analysis of risk factors. South Med J 2005;98(4):419–22