Dr Homa K. Ahmadzia (Maternal-Fetal Medicine specialist and Assistant Professor in the Department of Obstetrics and Gynecology at George Washington University hospital, USA) and Dr Jarmila A. Zdanowicz (Senior Consultant in Obstetrics and Gynecology, Clinical Head Maternity Unit, Fellow in Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Bern University Hospital, Switzerland), discuss severe postpartum haemorrhage (also called PPH). To set the scene, they explain important definitions and real-world incidence, in particular in higher resourced and less resourced countries. What is the difference between non-severe and severe PPH? What specialities are involved? And what are the consequences when PPH is not treated correctly? Additionally, Dr Ahmadzia and Dr Zdanowicz consider who is at risk, what measures can be used to diagnose, and the importance of prevention as well as treatment.