By Daniel Kamara
Africa-Press – Uganda. Postpartum haemorrhage (PPH) is a leading cause of maternal mortality worldwide, yet its deadliness often traces back to a far older and quieter threat: malnutrition.
As a nutritionist who has worked with communities across Uganda, I have repeatedly observed how poor maternal nutrition lowers a woman’s physiological reserve long before labour begins, making even moderate blood loss catastrophic.
To prevent PPH and protect mothers and babies, we must confront the vicious cycle of malnutrition—and use pragmatic, food-based solutions that are available, accessible, utilised, sustainable, and feasible.
The vicious cycle of malnutrition
The cycle begins with inadequate maternal nutrition prior to and during pregnancy. Women with depleted iron, folate, protein, and micronutrient stores enter labour with low haemoglobin and diminished ability to tolerate blood loss.
If PPH occurs, the bleeding compounds iron and protein deficits, delaying recovery and weakening lactation.
A weakened mother is less able to breastfeed or care for her infant, increasing the child’s risk of growth faltering and illness.
A malnourished girl who survives infancy is more likely to become a malnourished adolescent and, later, a malnourished mother- repeating the cycle across generations.
Poverty, food insecurity, infectious disease, frequent pregnancies, and gendered food allocation all help sustain this loop.
Breaking it requires both clinical readiness for PPH and upstream nutrition actions that strengthen mothers long before delivery and restore them promptly afterwards.
Nutrition priorities to reduce PPH risk
Prevent and treat maternal anaemia. Routine screening for haemoglobin during antenatal visits, universal iron–folic acid supplementation, and prompt treatment of moderate to severe anaemia are core interventions.
Where oral iron is not tolerated, or when severe anaemia is identified, referral and appropriate clinical management are essential.
Food-based approaches that build reserves. Supplements must be paired with locally appropriate dietary guidance so that households have sustainable access to iron, protein, and other critical nutrients.
Postpartum recovery and follow-up. Many women lose additional haemoglobin after delivery; continuing iron therapy when indicated, supporting nutritious postpartum diets, and community follow-up reduce the risk of prolonged functional impairment.
Foods that support mother and baby
Emphasise diversity, portion adequacy, and preparation methods that maximise nutrient retention and absorption.
Highly bioavailable iron & protein sources: Small fish, eggs, poultry, lean beef, and organ meats provide haem iron and quality protein that rapidly restore iron stores and support tissue repair after blood loss.
Legumes and pulses: Beans, lentils, cowpeas, and groundnuts are affordable sources of iron, protein, and energy, and are essential for both pregnancy and lactation. Combining legumes with cereals improves overall protein quality.
Dark leafy greens: Amaranth, Sukuma wiki, collard greens, pumpkin leaves, and spinach are rich in non-haem iron, folate, and vitamin A precursors; these support red blood cell production and immune function.
Orange-fleshed sweet potato and pumpkin: Excellent sources of provitamin A, important for maternal stores and infant vitamin A status through breastmilk.
Whole grains and traditional staples: Millet, sorghum, and whole maize provide energy and micronutrients; choose less-refined forms to preserve fibre and nutrient content.
Vitamin C–rich fruits: Guava, citrus, mango, and tomatoes enhance absorption of plant iron when eaten with iron-rich meals.
Dairy or calcium sources: Milk, yoghurt, and small fish eaten with bones supply calcium for maternal bone health and may support lactation.
Fortified staples and micronutrient powders: Where available, fortified flours and point-of-use micronutrient powders can fill dietary gaps for women and young children.
Community actions
Nutrition interventions must be woven into routine maternal care and community life. Train community health workers to screen for anaemia, counsel on iron-rich recipes, support adherence to supplements, and monitor postpartum recovery.
Promote kitchen gardens and link school feeding and local market procurement to nutrient-dense crops so that supply and demand reinforce one another. Use women’s savings groups and youth clubs to bulk-purchase fortified staples and coordinate seed banks.
These community-centric strategies create sustainable access to the foods that prevent and mitigate PPH.
Kamara Daniel, is a nutritionist at Bwindi Community Hospital
For More News And Analysis About Uganda Follow Africa-Press
