Factors Associated with Postpartum Hemorrhage among Pregnant Women in Enugu North Local Government Area, Enugu State, Nigeria

Abstract

Background: Maternal mortality remains a major global health challenge, with postpartum hemorrhage (PPH) identified as the leading direct obstetric cause of maternal deaths, particularly in low- and middle-income countries. Despite being largely preventable, PPH continues to contribute significantly to maternal morbidity and mortality in Nigeria. This study assessed the factors associated with postpartum hemorrhage among pregnant women in Enugu North Local Government Area, Enugu State, Nigeria. Methods: A descriptive cross-sectional study design was employed among 220 pregnant women selected from health facilities in Enugu North LGA. Data were collected using a structured questionnaire covering sociodemographic characteristics, obstetric history, antenatal care utilization, and awareness of PPH. Data were analyzed using SPSS version 25. Descriptive statistics were presented using frequencies and percentages, while chi-square tests were used to determine associations at a 5% level of significance (p < 0.05). Results: The prevalence of postpartum hemorrhage among respondents was 23.6%. Significant factors associated with PPH included age (p = 0.006), parity (p = 0.007), antenatal care attendance (p = 0.003), history of PPH (p < 0.001), prolonged labour (p = 0.009), anaemia in pregnancy (p = 0.002), place of delivery (p = 0.006), and skilled birth attendance (p = 0.040). Although general awareness of PPH was relatively high (73.6%), only 39.1% of respondents demonstrated good overall knowledge. Conclusion: Postpartum hemorrhage remains a significant maternal health challenge in Enugu North LGA, driven by obstetric risk factors and suboptimal utilization of antenatal and skilled birth services. Strengthening antenatal care, improving early risk identification, and ensuring skilled birth attendance are essential to reducing the burden of PPH in the study area.