By PPH Foundation

Not all maternal emergencies begin in the delivery room. Some begin months earlier with poor nutrition, untreated anaemia, and missed opportunities to build a woman's health during pregnancy. As countries work to reduce preventable maternal deaths, experts are increasingly highlighting maternal nutrition programmes and iron supplementation as critical interventions that strengthen women's ability to survive childbirth complications, including postpartum haemorrhage.

Maternal health experts continue to warn that anaemia remains one of the most common conditions affecting pregnant women worldwide. When a woman enters labour with low haemoglobin levels, her body is less able to withstand blood loss during childbirth, increasing the risk of severe complications and death if postpartum haemorrhage occurs.

According to the World Health Organization, approximately one in three pregnant women globally is affected by anaemia, with iron deficiency remaining the leading cause. WHO recommends routine iron and folic acid supplementation during pregnancy as part of quality antenatal care to improve maternal health and reduce adverse pregnancy outcomes. Research has consistently shown that iron supplementation significantly reduces maternal anaemia and iron deficiency during pregnancy.

Recent evidence continues to reinforce the importance of maternal nutrition programmes. Studies have shown that women who receive iron supplementation during pregnancy are less likely to experience severe anaemia at delivery and in the postpartum period, improving their ability to survive obstetric emergencies, including postpartum haemorrhage. Research further demonstrates that antenatal iron supplementation contributes to improved maternal haemoglobin levels and reduces the need for blood transfusion following delivery.

Despite these benefits, adherence to iron and folic acid supplementation remains a challenge in many low- and middle-income countries. In Kenya and across sub-Saharan Africa, anaemia continues to affect a significant proportion of pregnant women, often due to poor nutrition, delayed antenatal care attendance, infections, and inconsistent use of supplements.

Prof Moses Obimbo, Project Lead of the End Postpartum Haemorrhage Initiative, says maternal nutrition remains a critical but sometimes overlooked component of preventing maternal deaths.

“A woman with low blood levels becomes increasingly vulnerable as pregnancy progresses. If excessive bleeding occurs during childbirth, her chances of surviving are significantly reduced. Strengthening maternal nutrition programmes and ensuring women receive iron supplementation during pregnancy can make the difference between life and death,” says Prof Obimbo.

This message aligns with Prof Obimbo's previous public advocacy, where he has consistently emphasized the importance of maintaining adequate blood levels during pregnancy and the role they play in reducing complications associated with postpartum haemorrhage.

Experts further note that maternal nutrition programmes should go beyond supplementation alone. Access to nutritious foods, early antenatal care, nutrition counselling, screening for anaemia, and community awareness are all essential components of improving maternal health outcomes. Counties and health systems are also increasingly exploring multiple micronutrient supplementation programmes as part of broader efforts to address maternal anaemia and strengthen pregnancy outcomes.

As countries work to reduce maternal mortality, maternal nutrition programmes remain among the most cost-effective and evidence-based interventions available. Ensuring that every pregnant woman has access to iron supplementation and adequate nutrition could save thousands of mothers' lives and strengthen efforts to end preventable deaths from postpartum haemorrhage.

Sources

1. World Health Organization. Daily Oral Iron Supplementation During Pregnancy. Geneva: World Health Organization; 2025. Available from: https://www.who.int/tools/elena/review-summaries/daily-iron-pregnancy-malaria--daily-oral-iron-supplementation-during-pregnancy.
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3. Mwangi MN, Roth JM, Smit MR, et al. Effect of Daily Antenatal Iron Supplementation on Plasmodium Infection in Kenyan Women: A Randomized Clinical Trial. JAMA. 2015;314(10):1009–1020.
4. Nanjala M, Wambui J, et al. Adherence to Iron and Folic Acid Supplementation During Pregnancy Among Postnatal Mothers Seeking Maternal and Child Healthcare at Kakamega Level 5 Hospital in Kenya. F1000Research. 2021;10:691.
5. Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW. Anaemia, Prenatal Iron Use, and Risk of Adverse Pregnancy Outcomes: Systematic Review and Meta-Analysis. BMJ. 2013;346:f3443.
6. Makueni County Government. Makueni Leads Nation in Rollout of Lifesaving Maternal Nutrition Supplements. Makueni County Health Department; 2026.
7. Image by Freepik