Postpartum hemorrhage is leading cause of maternal death; doctors urge selection of birthplace based on risk factors
Postpartum hemorrhage is the leading cause of maternal death in Taiwan, and amniotic fluid embolism is a rare and unpredictable risk, doctors warn. They emphasize the importance of choosing an appropriate birthplace, recommending that pregnant women with risk factors deliver in well-equipped hospitals.
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- 📰 Published: April 24, 2026 at 17:19
- 🔍 Collected: April 24, 2026 at 17:32 (12 min after Published)
- 🤖 AI Analyzed: April 24, 2026 at 21:23 (3h 51m after Collected)
Central News Agency
(Central News Agency reporter Shen Pei-yao, Taipei, April 24) Postpartum hemorrhage is the leading cause of death among pregnant and lying-in women. Experts pointed out today that postpartum hemorrhage is not a risk exclusive to older mothers, and "amniotic fluid embolism" is extremely rare and cannot be prevented. They suggest asking doctors about risk factors before deciding on a suitable place for delivery.
Childbirth is an extreme challenge, a tug-of-war with death. Taiwan's "Act for Relief of Birth Accident" was implemented on June 30, 2016. According to the latest birth accident relief report from the Ministry of Health and Welfare, as of December 31, 2024, a total of 174 cases of maternal death relief have been recorded.
The report also analyzed the top 5 causes of maternal death: the first was postpartum hemorrhage, with 53 cases, accounting for 30.5%; followed by vascular embolism/pulmonary embolism with 34 cases, accounting for 19.5%; then amniotic fluid embolism with 32 cases (18.4%), cardiovascular diseases with 19 cases (10.9%), and intracranial hemorrhage with 16 cases (9.2%).
Recently, a female police officer unfortunately passed away due to excessive postpartum blood loss. Shih Ching-Chung, Director of Obstetrics at National Taiwan University Hospital's Department of Obstetrics and Gynecology, told the media today that postpartum hemorrhage is not limited to older mothers. The most common causes include placenta previa and uterine atony caused by prolonged induction of labor.
Shih Ching-Chung pointed out that with the increasing rate of cesarean sections, the probability of developing placenta previa or placenta accreta in subsequent pregnancies also increases. Current medical technology can reduce blood loss through medications and devices like the "Bakri Balloon."
Another extremely rare possibility is "amniotic fluid embolism." Shih Ching-Chung frankly stated that there are currently no specific risk factors to predict or prevent this condition, and its incidence rate is about one in ten to twenty thousand. Amniotic fluid embolism usually occurs in two stages: the first stage is heart failure, and if the mother survives this, she will enter severe postpartum hemorrhage.
The diagnosis of amniotic fluid embolism is also challenging. Shih Ching-Chung said that clinical signs such as a sudden drop in fetal heart rate, maternal hypoxemia, and ultrasound showing enlarged right atrium and ventricle are often more diagnostically significant than pathological dissection, because pathological dissection may not always reveal the crucial thrombus. Although ECMO (extracorporeal membrane oxygenation) can be attempted in treatment, it requires anticoagulants, which can sometimes worsen severe hemorrhage.
This has led some members of the public to worry, thinking that giving birth in a large hospital would be safer. Shih Ching-Chung emphasized, "As long as there is birth, there is risk." The advantage of giving birth in a large hospital is sufficient blood supply, allowing for timely assistance in case of severe hemorrhage, and the availability of multiple specialists who can promptly deal with thrombosis. "But don't expect that nothing will go wrong just because you give birth in a large hospital."
Outsiders speculate whether one's profession increases the risk, but Shih Ching-Chung clearly stated: "It should be unrelated." He explained that postpartum hemorrhage can occur in any pregnant woman, and the causes are more related to prolonged induction of labor, placenta previa, or placenta accreta.
Huang Min-Chao, Vice Superintendent of Mackay Memorial Hospital and an obstetrician-gynecologist, stated that if a pregnant woman has the following conditions, it is recommended to choose a hospital with better-equipped facilities for delivery to reduce risks: those with poorly controlled diabetes or high blood pressure, twins, fetal growth restriction, high risk of fetal distress, obese mothers, those with a history of difficult labor, or a history of postpartum hemorrhage in a previous pregnancy.
The government provides 14 free prenatal check-ups. Huang Min-Chao said that during prenatal check-ups, blood pressure, weight changes, and the baby's growth curve should be closely monitored. Pregnant women should discuss their medical history and risk factors with their primary obstetrician, such as poorly controlled blood sugar and blood pressure, or a fetus that is too large or too small, to jointly decide on a suitable place for delivery, whether in a clinic or a hospital. If everyone goes to medical centers for delivery, it may lead to an overwhelming burden on medical capacity. (Editor: Lung Po-an) 1150424
(Central News Agency reporter Shen Pei-yao, Taipei, April 24) Postpartum hemorrhage is the leading cause of death among pregnant and lying-in women. Experts pointed out today that postpartum hemorrhage is not a risk exclusive to older mothers, and "amniotic fluid embolism" is extremely rare and cannot be prevented. They suggest asking doctors about risk factors before deciding on a suitable place for delivery.
Childbirth is an extreme challenge, a tug-of-war with death. Taiwan's "Act for Relief of Birth Accident" was implemented on June 30, 2016. According to the latest birth accident relief report from the Ministry of Health and Welfare, as of December 31, 2024, a total of 174 cases of maternal death relief have been recorded.
The report also analyzed the top 5 causes of maternal death: the first was postpartum hemorrhage, with 53 cases, accounting for 30.5%; followed by vascular embolism/pulmonary embolism with 34 cases, accounting for 19.5%; then amniotic fluid embolism with 32 cases (18.4%), cardiovascular diseases with 19 cases (10.9%), and intracranial hemorrhage with 16 cases (9.2%).
Recently, a female police officer unfortunately passed away due to excessive postpartum blood loss. Shih Ching-Chung, Director of Obstetrics at National Taiwan University Hospital's Department of Obstetrics and Gynecology, told the media today that postpartum hemorrhage is not limited to older mothers. The most common causes include placenta previa and uterine atony caused by prolonged induction of labor.
Shih Ching-Chung pointed out that with the increasing rate of cesarean sections, the probability of developing placenta previa or placenta accreta in subsequent pregnancies also increases. Current medical technology can reduce blood loss through medications and devices like the "Bakri Balloon."
Another extremely rare possibility is "amniotic fluid embolism." Shih Ching-Chung frankly stated that there are currently no specific risk factors to predict or prevent this condition, and its incidence rate is about one in ten to twenty thousand. Amniotic fluid embolism usually occurs in two stages: the first stage is heart failure, and if the mother survives this, she will enter severe postpartum hemorrhage.
The diagnosis of amniotic fluid embolism is also challenging. Shih Ching-Chung said that clinical signs such as a sudden drop in fetal heart rate, maternal hypoxemia, and ultrasound showing enlarged right atrium and ventricle are often more diagnostically significant than pathological dissection, because pathological dissection may not always reveal the crucial thrombus. Although ECMO (extracorporeal membrane oxygenation) can be attempted in treatment, it requires anticoagulants, which can sometimes worsen severe hemorrhage.
This has led some members of the public to worry, thinking that giving birth in a large hospital would be safer. Shih Ching-Chung emphasized, "As long as there is birth, there is risk." The advantage of giving birth in a large hospital is sufficient blood supply, allowing for timely assistance in case of severe hemorrhage, and the availability of multiple specialists who can promptly deal with thrombosis. "But don't expect that nothing will go wrong just because you give birth in a large hospital."
Outsiders speculate whether one's profession increases the risk, but Shih Ching-Chung clearly stated: "It should be unrelated." He explained that postpartum hemorrhage can occur in any pregnant woman, and the causes are more related to prolonged induction of labor, placenta previa, or placenta accreta.
Huang Min-Chao, Vice Superintendent of Mackay Memorial Hospital and an obstetrician-gynecologist, stated that if a pregnant woman has the following conditions, it is recommended to choose a hospital with better-equipped facilities for delivery to reduce risks: those with poorly controlled diabetes or high blood pressure, twins, fetal growth restriction, high risk of fetal distress, obese mothers, those with a history of difficult labor, or a history of postpartum hemorrhage in a previous pregnancy.
The government provides 14 free prenatal check-ups. Huang Min-Chao said that during prenatal check-ups, blood pressure, weight changes, and the baby's growth curve should be closely monitored. Pregnant women should discuss their medical history and risk factors with their primary obstetrician, such as poorly controlled blood sugar and blood pressure, or a fetus that is too large or too small, to jointly decide on a suitable place for delivery, whether in a clinic or a hospital. If everyone goes to medical centers for delivery, it may lead to an overwhelming burden on medical capacity. (Editor: Lung Po-an) 1150424