The Women-2 Trial -Tranexamic acid for preventing postpartum haemorrhage

Every year, around 100,000 women die from severe bleeding after childbirth, and many more survive with lasting health problems. This trial tackles a critical timing gap. The drug tranexamic acid (TXA) stabilises blood clots and is known to reduce deaths when given *after* postpartum haemorrhage (PPH) has already started. But for many women—especially those with anaemia—treatment comes too late. The WOMAN-2 trial asks whether giving TXA *immediately* after birth, before bleeding begins, can prevent PPH from happening in the first place. The researchers will recruit 10,000 anaemic women, giving half TXA and half a placebo, then compare rates of PPH between the two groups. If TXA proves effective as a preventive measure, it could change standard maternity care worldwide, particularly in low-resource settings where anaemia is common and access to emergency treatment is limited. Because intravenous TXA is impractical in many primary care clinics, a parallel study will also explore alternative ways to administer the drug—such as oral or intramuscular forms—potentially making prevention feasible in the most remote settings.