Abstract Background Postpartum haemorrhage (PPH) is a leading cause of mortality and morbidity globally. While studies have revealed disparities in maternal and fetal outcomes, disparities in PPH risk within diverse populations remains understudied. Objectives To quantify the association between maternal race, ethnicity, deprivation and the risk of PPH in High Income Countries (HIC’s). Search strategy A systematic search of MEDLINE, CINAHL, EMBASE and Google Scholar from inception to 20 th August 2024. Selection criteria Observational and experimental studies from HICs that reported the outcome of PPH, in at least two racial, ethnic or socioeconomic groups. Data collection and analysis Two reviewers performed independent data extraction. Random-effects model was used to estimate risk. Subgroup analysis was performed by geographical region and time period. Main results 79 studies with 169,579,388 women were included. Women from an ethnic minority background had an increased risk of PPH, compared to White women. This effect was seen across Black women (OR 1.16, 95% CI 1.09,1.23), Asian women (OR 1.33, 95% CI 1.27, 1.39), Hispanic women (OR 1.20, 95%CI 1.12, 1.29), and women from the minority ethnic group within a given study (OR 1.13 95% CI 1.03,1.24). Eight studies reporting PPH per socioeconomic group reported increased risk of PPH for those living in socioeconomic deprivation. Conclusions Women from an ethnic minority background or exposed to socioeconomic deprivation had an increased risk of PPH in high income settings. Standardisation of data collection on ethnicity, race and socioeconomic status is crucial for future research to accurately quantify and address these disparities. Funding: There was no funding source for this study. Keywords: Maternal health disparities, ethnicity, race, socioeconomic deprivation, postpartum haemorrhage