Postpartum hemorrhage management steps are essential for every healthcare provider. Rapid action can save lives when severe bleeding occurs after delivery. Recognizing PPH early, following structured interventions, and coordinating team responses ensures better maternal outcomes.
The average human has 6 liters of blood, or 6000 ml. The average pregnant uterus has a blood flow of 600 – 700ml per minute. When bleeding from the uterus, a lot of blood can be lost quickly. Fast, efficient actions save lives.
1. Call for Immediate Help in Postpartum Hemorrhage Management
The first step in postpartum hemorrhage management is to activate the emergency response team immediately. Rapid escalation guarantees faster access to medications, blood products, and senior support.
2. Assess and Monitor Maternal Vital Signs
For effective postpartum hemorrhage management, continuously monitor blood pressure, heart rate, respiratory rate, and oxygen saturation. Regular assessments identify early deterioration and guide timely interventions.
3. Perform Fundal Massage to Reduce Bleeding
Fundal massage is a core postpartum hemorrhage management step. Firm uterine stimulation helps restore tone, minimize blood loss, and prevent recurrence after placental expulsion.
4. Administer Uterotonic Medications Promptly
Administer oxytocin, misoprostol, or other uterotonics following protocol. This step strengthens uterine contraction and is crucial in postpartum hemorrhage management to stabilize the patient quickly.
5. Establish IV Access and Begin Rapid Fluid Resuscitation
Insert two large-bore IV lines and start rapid infusion of crystalloids. Blood transfusion should follow if bleeding persists. Early IV access is a vital postpartum hemorrhage management step to prevent shock.
6. Identify the Cause Using the 4 T’s Framework
Determine the cause by evaluating Tone, Trauma, Tissue, and Thrombin. Correctly identifying the source allows targeted treatment, making this a critical postpartum hemorrhage management step.
7. Control and Repair Trauma Quickly
Check for cervical, vaginal, or perineal lacerations. Prompt repair prevents ongoing blood loss and is essential in any postpartum hemorrhage management plan.
8. Remove Retained Placental Tissue or Clots
Manually or surgically remove any retained placenta or clots. This restores uterine tone and supports other postpartum hemorrhage management steps.
9. Escalate to Advanced Interventions When Needed
When initial measures fail, proceed to advanced options such as uterine balloon tamponade, surgical procedures (e.g., B-Lynch or hysterectomy), or interventional radiology.
Timely escalation saves lives and should never be delayed.
10. Provide Continuous Monitoring and Emotional Support
Finally, maintain close monitoring of blood loss, vital signs, and hemoglobin levels.
Alongside clinical management, offer emotional reassurance and psychological support to the mother and her family throughout recovery.
Collaborative Readiness Saves Lives
Managing postpartum hemorrhage effectively depends on teamwork, rapid communication, and consistent training.
Regular simulation drills, updated protocols, and interdisciplinary coordination are key to improving maternal outcomes and ensuring readiness in every setting.
Maternal 911 Education Systems, LLC is a leader in emergency obstetrics and team training, improving outcomes through education and evidence-based practice. Maternal 911 Education Systems, LLC is led by a team of experts in emergency obstetrics and maternal safety, dedicated to improving outcomes through evidence-based, team-centered education. Passionate about maternal health education, Maternal 911 advocates for evidence-based practices and interdisciplinary team training. Their mission is to reduce pregnancy risks through education and emergency training. Learn more at maternal911.com.
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Disclaimer: Educational use only — not a substitute for clinical judgment or local protocols.
