Design and context of use of postpartum haemorrhage kits in the UK: a qualitative study combining human factors and social science analysis

Effective management of postpartum haemorrhage (PPH) - a leading cause of maternal mortality - depends on rapid access to critical equipment and medications. PPH emergency kits support timely care, but their design and practical use remain largely unexamined. We combined human factors and social science analysis - drawing on photographs, field observations, and 19 interviews with maternity professionals - to examine kit designs, usability, and contextual factors in six UK maternity units. Many design features, including kit format, item grouping, item visibility, and portability, varied substantially across units. Usability was shaped by factors including labour room and storage constraints, medication access, staff skill mix, and restocking procedures. Some designs risked delays or confusion in emergencies. While standardisation may improve kit safety and efficiency, rigid solutions may risk misalignment with local workflows. A modular approach combining standardised core components with adaptable elements, co-designed with end-users and grounded in ergonomic principles may provide an effective solution. HighlightsO_LIEmergency kits support timely management of life-threatening postpartum haemorrhage. C_LIO_LIWe used human factors and social science to examine kit design and context of use. C_LIO_LIKit format, configuration, and portability varied across six maternity units. C_LIO_LIKit design was highly variable, with implications for usability and risk. C_LIO_LIModular kits may improve safety by combining standardised and adaptable features. C_LI