 BACKGROUND: Each year, worldwide about 530,000 women die from causes related to pregnancy and childbirth. Almost all 99 of the deaths are in low and middle income countries. Obstetric haemorrhage is the leading cause of maternal mortality accounting for between one quarter and one third of deaths, most of which occur in the postpartum period. About 14 million mothers develop postpartum haemorrhage PPH each year and about 1-2 of them will die, with an average interval from onset to death of about 2 to 4 hours. Obstetric haemorrhage is also an important cause of maternal mortality in high income countries where it accounts for about 13 of maternal deaths. 