Four low-cost measures during pregnancy and childbirth could save the lives of 200,000 mothers by 2040, according to a report by the Gates Foundation.

The steps are proven to reduce deaths from bleeding but are not being used across the world partly due to a lack of awareness of their impact, the report suggested.

Post-partum haemorrhaging (PPH) results in 70,000 deaths every year, the biggest killer of new mothers. Tackling it is crucial on the way to reaching the United Nations Sustainable Development Goal of cutting maternal deaths to 70 per 100,000 births. The Gates Foundation estimates that at current rates of progress that figure will be twice as high by the 2030 deadline. 

Teaching doctors and midwives to combine methods they already use, such as basic drugs, massaging of the uterus and intravenous drips could make a big dent in the figure, the researchers said. They described this as a PPH management bundle. Additionally giving pregnant women iron in a drip could help prevent anemia which worsens bleeding; while a common antibiotic known as azithromycin helps to prevent the onset of fatal sepsis. The final method involves using ultrasound.

"For nearly all of human history, we simply didn’t know enough about preventing or treating the common childbirth complications that lead to death, such as postpartum hemorrhage or infection," wrote Melinda French Gates in the report. "Today, we know a great deal. Yet, as is so often the case in global health, innovations aren’t making their way to the people who need them most."