**6. Conclusions**

In conclusion, the problems of PPH concerned the Thai government. Many projects were carried out in accordance with World Health Organization's (WHO) [16] guidelines to reduce PPH, PPH-related hysterectomy, and maternal death.

Due to some settings in Thailand, the government's policy is not suitable for some women because of their low resources and distance from the cities. Some of the settings are surrounded by mountains and forests, and it is very hard to refer a pregnant woman with PPH to the provincial hospital. Most of them belong to different ethnic groups and cannot communicate with other people. Therefore, some of them die before seeing a doctor.

There should be a policy of early detection of PPH in those lower resource settings by using an appropriate risk score tool to predict the PPH risk for a pregnant woman's life.

### **Acknowledgements**

The authors would like to thank all of the respondents for their valuable contributions to this study and extend their special gratitude to the Department of Obstetrics and Gynecology in Chiang Rai Regional Hospital and Sakon Nakhon Hospital for the data support, and the Thai Society of Maternal and Fetal Medicine for funding support.
