Midwives’ Voices on Postpartum Hemorrhage: An Exploratory Qualitative Study

Background: This study aimed to explore midwives' experiences, perceptions, and recommendations concerning the prevention, diagnosis, and management of postpartum hemorrhage (PPH). Methods: An exploratory qualitative design was employed, using semi-structured, in-depth interviews. The study was conducted in public hospitals and maternity units across Türkiye. Seventeen midwives with direct experience in postpartum hemorrhage management participated in the study. Data were collected through individual interviews and were analyzed thematically following Braun and Clarke’s framework. Verbatim transcripts were coded, categorized, and synthesized into overarching themes. Results: Five main themes emerged: (1) clinical preparedness and response capacity, (2) health system and access barriers, (3) team dynamics and crisis management, (4) training and policy gaps, and (5) facilitative strategies. Midwives reported challenges such as equipment shortages, delays in accessing physicians, and role ambiguity during emergencies. They also emphasized training needs, inadequate antenatal education, and weak family planning policies. Conversely, facilitators such as hemorrhage kits, planned blood reserves, and mentorship from experienced staff were perceived as valuable in strengthening care. Conclusion: Midwives play a pivotal role in the early recognition and management of PPH. However, systemic barriers and limited professional authority frequently hinder timely interventions. Strengthening midwives’ competencies through regular simulation-based training, ensuring the availability of essential resources, and strengthening midwifery roles within health policies can improve the prevention and management of postpartum hemorrhage and promote maternal safety. Clinical trial number Not applicable.