By PPH Foundation

A woman arrives at a maternity ward with severe postpartum haemorrhage. She needs an urgent blood transfusion, but compatible blood is not immediately available because her blood type is rare or she has uncommon red blood cell antibodies. In a condition where every minute counts, such delays can mean the difference between life and death.

Most people know the ABO and Rhesus blood groups, but there are more than 600 recognized red blood cell antigens grouped into over 40 blood group systems. Some women carry rare blood types or antibodies against antigens making it more difficult to find compatible blood during obstetric emergencies. Although these antibodies are uncommon, they remain an important cause of transfusion complications and support the need for routine antibody screening during pregnancy (Gibbins et al., 2025).

Postpartum haemorrhage often occurs unexpectedly and can require multiple units of blood within a short time. Blood must not only be available but also compatible. Where specialised laboratory services or rare donor registries are limited, identifying suitable blood may take longer, increasing the risk of severe complications or death.

The World Health Organization identifies timely access to safe blood and blood products as a core component of comprehensive emergency obstetric care. Delays in transfusion are associated with poorer maternal outcomes, including hysterectomy, multi-organ dysfunction and maternal death (WHO, 2023).

Kenya continues to face challenges in meeting the growing demand for blood, particularly during obstetric emergencies. Rare blood groups add another layer of complexity, making it essential to strengthen not only blood donation but the entire blood system.

During the recent National Stakeholder Engagement on Blood and Blood Products for Maternal Health and Priority Clinical Needs, convened by the PPH Foundation, stakeholders emphasised the need to invest in donor retention, laboratory capacity, antibody screening, cold-chain systems, digital blood inventory management and efficient referral networks to ensure compatible blood reaches mothers without delay.

Prof Julius Ogeng'o, Co-Lead of the EndPPH Initiative, underscores the importance of resilient blood systems:

"Every obstetric emergency reminds us that blood is more than a medical commodity. It is a lifesaving resource that depends on efficient systems, skilled personnel and coordinated planning. When compatible blood is delayed, the consequences can be devastating for mothers experiencing postpartum haemorrhage. Building resilient blood systems is therefore an investment in saving lives."

Healthcare providers can also reduce delays through antenatal blood grouping and antibody screening, early identification of women at high risk of postpartum haemorrhage, timely referral of complex pregnancies and multidisciplinary emergency preparedness.

As Kenya works to reduce preventable maternal deaths, strengthening blood systems must go beyond increasing donations. Investment in laboratory services, compatible blood matching, donor diversity and efficient emergency blood distribution is essential to ensuring that every mother receives the lifesaving transfusion she needs, when she needs it.

References

Gibbins, K. J., et al. 2025. Maternal red blood cell alloimmunization and pregnancy outcomes. JAMA Network Open, 8(3), e2544649.

World Health Organization. 2023. WHO recommendations for the prevention and treatment of postpartum haemorrhage. Geneva, Switzerland.

World Health Organization. 2025. Global database on blood safety and availability. Geneva, Switzerland.

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