Introduction: Postpartum hemorrhage is defined as any blood loss more than 500 ml following vaginal delivery and more than 1000 ml after cesarean section within 24 hours of delivery. Postpartum hemorrhage is the leading cause of maternal mortality and morbidity worldwide, particularly in resource-limited country such as Ethiopia. Findings from a few studies were inconsistent and there is a need to systematically pool existing data to determine the magnitude of postpartum hemorrhage and its association with Antenatal care follow up among women who gave birth in Ethiopia.

Methods: Electronic databases such as Medline, Pub Med, Cochrane library, the Web of Science and Google Scholar were used to search for articles. The search period for articles was conducted from 15^th August 2019 to 15^th November 2019. Data were extracted using a standardized data extraction checklist and the analyses were conducted using STATA version 14. The Cochrane Q test statistic and I ² tests were used to assess heterogeneity. To estimate the pooled magnitude of postpartum hemorrhage, a random-effects model was fitted. Association between postpartum hemorrhage and antenatal care follow up was reported in Odds Ratio (OR) with 95% Confidence Interval (CI).

Results: A total of 98 studies were identified from several databases and seven studies fulfilled eligibility criteria and were included in the meta-analysis. The pooled magnitude of postpartum hemorrhage in Ethiopia was 12.88 % (95%CI: 7.40, 18.36). The current meta-analysis revealed that lack of antenatal care follow-up was significantly associated with postpartum hemorrhage (OR=0.11, 95%, CI: 0.04, 0.27).

Conclusion: In Ethiopia the magnitude of postpartum hemorrhage was high, and lack of antenatal care follow up was a risk factor for postpartum hemorrhage. Thus, improving ANC follow up are needed to decrease the magnitude of postpartum hemorrhage.

Keywords: Antenatal care, postpartum hemorrhage, systematic review, Ethiopia