When Joseph Wanyonyi speaks about his late wife, Phylis Wanjiru, his voice carries the weight of love, loss, and disbelief.
I never imagined I would be telling this story. On the night of September 10th, 2025, I became both a father again and a widower.
My wife, Phyllis, was more than a wife to me , she was my second mother. She loved our family deeply, especially our three children and the new baby girl. She remembered every school event, woke up before dawn to pack the children’s snacks, and always made sure I looked presentable before leaving home.
Losing her broke something inside me that will never heal.
On September 9, Phyllis and I left home in good spirits. She was expecting our fourth child her third caesarean section and we went to book an appointment with a gynecologist and a maternity ward at a private hospital. She looked perfectly fine, climbing stairs and joking with the nurses.
But soon after her check-up, everything changed. The doctor said she needed to go to theatre immediately. I remember asking, “Why? She’s not even in pain.” She was active, walking, and talking. Still, I trusted the doctors. I believed they knew what they were doing.
Around 2 p.m., Phyllis delivered a healthy baby. I was told both mother and child were fine. When I saw her later in the ward, she was smiling and chatting. We talked for hours. She laughed and said she was hungry. Then she began complaining of pain.
The nurses said it was normal after a C-section. Later, she told me she was feeling cold again, I was told it was normal. I left that evening to check on our other children.
At about 9 p.m., my phone rang. I called her back immediately. Her voice was shaky. “Babe, I’m scared,” she said. “They want to refer me to Kenyatta National Hospital. Please come.”
I grabbed my jacket and ran out.
When I arrived, they wouldn’t let me see her. She was being moved into an ambulance. I sat at the front as we drove to Kenyatta National Hospital (KNH). No one explained what was happening. It had been nearly seven hours since she delivered, and I didn’t know she was bleeding internally losing almost four litres of blood.
At KNH, confusion greeted us. The nurses who accompanied her didn’t seem to know her full condition. I overheard one KNH nurse ask sharply, “What is going on with this lady?” There was visible tension between the two teams.
Then I heard the words that haunt me to this day: “She has lost a lot of blood.”
They said she needed three pints for transfusion before surgery. Her blood group was O negative , a rare type. Only one pint was available. I waited outside, praying. After about two hours, I was told she was conscious again. The doctors suspected her uterus was the problem and recommended surgery to remove it. I remember her whispering, “Do whatever it takes to make me okay.” We signed the consent forms.
They operated on her, but the bleeding continued. Around 9 a.m. on September 10, I was called to the ICU. A doctor told me her condition was critical and asked me to find blood urgently.
I posted on social media. Friends and strangers began calling, offering to help. One close friend even parked her car and rushed to donate. Before she could reach the blood bank, the doctor came back.
“I’m sorry,” he said softly. “We lost her.”
Everything went dark.
That moment shattered my world.
I went home to four children two little girls , a son , and a newborn daughter who would never know her mother. I didn’t even know how to mix formula milk. The first week was unbearable. My grandmother helped me, but every time I looked at my baby, I saw Phyllis.
The postmortem confirmed massive postpartum haemorrhage. By the time she reached KNH, she had lost too much blood for her body to recover. The doctors did their best, but the damage had been done hours earlier.
Each year, about 14 million women experience PPH, and roughly 70,000 die from its complications. Most of these deaths occur in low- and middle-income countries, especially in sub-Saharan Africa and South Asia, where delays in detecting and treating excessive bleeding remain a major challenge.
In Kenya, the Ministry of Health estimates that PPH accounts for nearly 20 percent of all maternal deaths, meaning one in every five women who dies during childbirth succumbs to bleeding that could have been prevented.
WHO announced the revision of its definition of postpartum haemorrhage from blood loss of 500 millilitres to 300 millilitres or more within 24 hours of birth. This new threshold aims to promote earlier detection and faster intervention.
Experts agree that with proper monitoring, skilled health workers, and timely use of life-saving drugs such as oxytocin, carbetocin, and tranexamic acid, most of these deaths are preventable. Yet, many facilities face shortages of blood, essential drugs, and trained staff.
How does a woman lose four litres of blood without anyone noticing? How can she be “okay” one minute and gone the next?
The system failed my wife. Those seven hours, when she was bleeding and being reassured that everything was normal, were the difference between life and death.
By the time she reached KNH, it was too late. The doctors there were transparent and worked tirelessly. But they were fighting a battle that should never have started.
Each year, about 5,000 Kenyan women die from pregnancy-related causes, according to the Kenya Demographic and Health Survey (KDHS). PPH is the single largest contributor.
The E-MOTIVE trial, a landmark study led by WHO and partners, found that using a simple measuring device and standard treatment protocol reduced severe bleeding by 60 percent in hospitals that implemented it.
It’s been weeks since Phyllis died, but each day feels like that morning. I wake up early to prepare the children for school. My youngest daughter , Abigael , the second last born still asks, “When is mummy coming back from the hospital?” I have no answer.
I tell them their mother was strong, brave, and loved them deeply.
People often tell me to move on, but how do you move on from someone who gave you everything?
The Ministry of Health recently pledged to strengthen maternal and newborn care under the Linda Mama program and implement WHO’s latest PPH guidelines. That’s a good start, but policies only matter if they work on the ground.
For My Daughters
I’m raising three daughters, and I want them to live in a country where childbirth is safe, where motherhood isn’t a death sentence.
Sometimes I see my wife in their laughter, in their eyes. My son smiles just like her. Holding him reminds me of what we lost, but also why I must keep speaking.
Phyllis didn’t die in vain. Through her story, I hope someone,a doctor, a policymaker, a husband, will act before it’s too late for another woman.
“My wife was like a mother to me,” I often say, and it’s true. Losing her left a hole nothing can fill.
But if telling our story saves even one life, then maybe, just maybe, her death will not have been in vain.
Early Detection Could Save Thousands
The World Health Organization new guidelines to prevent postpartum haemorrhage the leading cause of maternal deaths globally. The revised recommendations now call for earlier detection of bleeding at 300 millilitres, down from 500 millilitres.
Reproductive health expert Dr. Dennis Miskellah has welcomed the move, calling it “a timely, evidence-based decision that will prevent unnecessary deaths.” He explains that research, especially from the E-MOTIVE trial, revealed that health workers often underestimate blood loss after childbirth. “By the time you notice 500 millilitres of blood loss, the woman may already have soaked through her clothes and bedding, and even blood clots . The new 300 mL limit allows us to catch haemorrhage earlier and begin lifesaving treatment immediately,” he said.
Dr. Miskellah noted that maternal deaths from PPH are caused not only by bleeding itself but also by delays in diagnosis, treatment, and access to blood or essential drugs. “By lowering the detection threshold, we eliminate one of those delays,” he explained. “Early intervention means prompt use of uterotonics and clotting agents like tranexamic acid.”
Uterotonics are medicines that help the uterus contract after childbirth. They are mainly used to stop or prevent heavy bleeding, which can be life-threatening if not managed quickly. While , Tranexamic acid is medicine that helps reduce bleeding by stopping the body from breaking down blood clots too quickly. This allows the blood to clot and stay in place, helping to control excessive bleeding after childbirth or surgery.
He added that when bleeding is detected late, women can lose several litres of blood nearly their entire supply. “The human body has around five litres of blood, and pregnancy increases that volume by about 50 percent,” he said. “If a woman loses four litres, as we’ve sadly seen in some cases, that’s catastrophic. Death can occur within minutes.”
He further explained that conditions such as uterine atony- a postpartum emergency where the uterus fails to contract after childbirth, preventing the closure of blood vessels and leading to excessive blood loss, retained placenta, or severe tears can prevent the uterus from contracting properly after delivery, leading to uncontrolled bleeding. He also warned that poor-quality drugs and improper storage worsen the problem. “For years, we’ve relied on oxytocin, but it requires refrigeration ,something many facilities lack. Carbetocin, which is heat-stable, is a safer alternative that could save more lives, although expensive” he said.
Carbetocin is a man-made version of the natural hormoneoxytocin, ( Oxytocin, often called the “love hormone,” helps build feelings of trust, closeness, and empathy between people. In childbirth, it plays a key role by triggering uterine contractions that help deliver the baby, and later, it supports breastfeeding by helping release milk from the breasts.) designed to last longer in the body. Doctors use it to help the uterus contract after delivery, reducing the risk of postpartum haemorrhage (PPH),severe bleeding that can occur after childbirth, especially during or after a caesarean section. While it works effectively to control bleeding, carbetocin is often more costly compared to oxytocin, which limits its availability in many hospitals.
Dr. Miskellah emphasised that no theatre performing a caesarean section should operate without blood on standby. “No mother should die because a facility lacked the basics,” he said. “Every hospital must have a standard emergency protocol, what we call a ‘Code Red’ where everyone drops what they’re doing to save that mother. Every minute counts.”
He reiterated that hospitals should be keen with women who have undergone CS previously they are at risk because of the surgeries. “Women go to hospitals trusting the system to protect them. That trust must never become their death sentence.”
Dr. Jane Muchira, a Health Policy Research and Development Lead at the Institute of Gender Responsive Health Systems, says postpartum haemorrhage (PPH) remains one of the most devastating yet preventable causes of maternal mortality in Kenya and its effects go far beyond the delivery room.
“PPH is the leading cause of maternal mortality in Kenya,” she begins firmly. “We really need to take this matter seriously because it’s not just about the loss of a mother. It disrupts families, it destabilises homes, and it damages the very social fabric of our communities.”
According to Dr. Muchira, the loss of a mother often sets off a painful chain reaction within the family.
“We often find that spouses of women who have succumbed to PPH are left with severe mental trauma,” she explains. “It’s hard to parent while grieving. Many end up depressed, and children in such households may turn to drugs, drop out of school, or get into early pregnancies. It’s a ripple effect that weakens the family unit the foundation of society.”
Beyond the emotional devastation, Dr. Muchira highlights the economic cost of maternal deaths.
“Women make up 36 percent of Kenya’s labour force, and the majority of them aged between 15 and 45 are in their childbearing years,” she notes. “In agriculture alone, women account for about 85 percent of the workforce. When mothers die, we’re not just losing lives; we’re losing active contributors to the economy.”
She gives an example of rural areas like Kilifi, where many households are headed by women. “When you lose mothers in such communities, you slow down local development. The economic implications are massive, and they reverberate across generations.”
Dr. Muchira believes that addressing PPH effectively requires multi-sectoral partnerships between government, the private sector, and civil society.
“The government is stretched thin,” she says. “We’re dealing with multiple health crises, including emerging outbreaks like Mpox. It’s difficult to give equal attention to all issues that’s why the private sector must step in.”
She proposes practical ways for collaboration:
“Private partners can help subsidise the cost of essential medication and invest in blood banks. Many level four hospitals, where most women deliver, have very limited blood storage facilities. The government can also subsidise private hospitals so they can handle PPH cases without burdening public facilities. Even women with basic insurance should be able to access emergency maternal care in private hospitals, with the government footing the bill.”
Another key pillar, according to Dr. Muchira, is training.
“We must ensure hospital staff are properly trained on the new WHO guidelines,” she stresses. “Lectures are not enough. We need intensive, hands-on training even if it takes weeks or months so that everyone, from nurses to consultants, can recognise the early signs of PPH and act immediately.”
She calls for a culture of accountability and learning in hospitals.
“If a woman dies in a ward, there should be a mortality review meeting. Let’s find out what went wrong and fix it. We can also identify women with high-risk pregnancies early and ensure they receive 24-hour monitoring. No mother should die because warning signs were missed.”
From a scientific standpoint, Dr. Muchira explains that many cases of PPH are missed because of gaps in antenatal care.
“A lot of women don’t get the proper follow-up during pregnancy,” she says. “Some hospitals lack ultrasound machines, so women must pay for scans elsewhere and not everyone can afford that. As a result, many go through pregnancy unaware they’re at risk for complications like placenta previa or uterine rupture.”
She adds that during childbirth, routine blood loss measurement is rarely practiced.
“In most hospitals, especially for vaginal births, it’s not standard to measure blood loss. You just deliver, and that’s it,” she says. “But if we adopt calibrated drapes to accurately measure bleeding as recommended by WHO, we can catch haemorrhage early and save lives.”
Calibrated drapes are specially designed plastic sheets used immediately after childbirth to measure blood loss accurately. Placed under the mother’s lower back, they collect and display the amount of blood lost using clearly marked measurement lines. This simple yet effective tool helps health workers detect postpartum haemorrhage (PPH) early before it becomes life-threatening. In many low-resource settings, where access to advanced equipment is limited, these drapes have become a lifesaving innovation in the fight against one of the leading causes of maternal death.
Callibrated drape image .
Dr. Muchira emphasizes that saving mothers must be treated as a national priority.
“We cannot afford to lose any more women to preventable bleeding,” she says. “We need better training, stronger blood banks, and clear emergency response protocols. Every mother’s life matters. When a woman dies giving life, it’s not just a tragedy it’s a national failure.”
1 comment
Very informative