Every seven minutes a mother dies from postpartum hemorrhage, and approximately half of these deaths occur following a vaginal birth. The primary reasons for the deaths are non- or delayed diagnosis of postpartum hemorrhage and inconsistent delivery of effective interventions. The E-MOTIVE intervention addresses these challenges through early and accurate detection of postpartum hemorrhage (E) using a calibrated blood collection drape, and timely and consistent delivery of effective interventions via the MOTIVE bundle (MOTIVE: uterine Massage, Oxytocic drugs, Tranexamic acid, Intra-Venous fluids, and Examination and Escalation). The E-MOTIVE trial is a multi-centre (78 hospitals), multi-country (Nigeria, Kenya, Tanzania, and South Africa) cluster-randomized trial that recruited more than 200,000 participants. The preliminary findings of this trial will be shared at this conference.