Maternal deaths associated with caesarean deliveries (CDs) have been increasing in South Africa over the past decade. The objective of this
report is to bring national attention to this increasing epidemic of maternal deaths due to bleeding associated with CD in the majority of
provinces of the country. Individual chart reviews of women who died from bleeding at or after CD show that 71% had avoidable factors.
Among the steps we can take are to improve surgical skills and experience, especially in rural hospitals; to improve clinical observations
in the immediate postoperative period and in the postnatal wards; and to ensure that appropriate oxytocic agents are given to prevent
postpartum haemorrhage. CEOs and medical managers of health facilities, district clinical specialists, heads of obstetrics and gynaecology,
and midwifery training institutions must show leadership and accountability in providing an appropriate environment to ensure that
women who require CD receive the procedure for the correct indications and in a safe manner to minimise risks.