The measure of a mother Accounting for the risk of postpartum haemorrhage in global health

In 2012, the World Health Organization (WHO) issued postpartum haemorrhage guidelines that recommended that all women giving birth should be offered uterotonics, particularly oxytocin, during the third stage of labour. This chapter unpacks the social and cultural history of this recommendation. First it considers how WHO experts, who linked postpartum haemorrhage to uterine failure, relied on studies of haemorrhage carried out in the global North and selectively overlooked cautions that scientists voiced about the limitations of their findings. It then considers alternative approaches to postpartum haemorrhage prevention, examining the work of a midwife-scientist whose research is premised on the idea that the uterus is strong and that the cause of haemorrhage lies not in the body of the birthing person but in the social and historical environment in which they birth. The ethnographic research presented in this chapter points to how global health haemorrhage recommendations have reproduced controversial ideas about pregnancy, appropriate intervention, and motherhood. It concludes by highlighting how to incorporate ‘measures of motherhood’ focused on reproductive in/justice (see Davis, 2016) into the design of maternal mortality policy.