Postpartum hemorrhage is excessive bleeding (hemorrhage) that occurs after delivery. (Normal bleeding after delivery is one to two cups of blood.)

a. Internal Bleeding. Causes of internal bleeding after delivery include retained placental products, inadequate uterine contractions, or clotting disorders. Treat as follows:

(1) If the bleeding is profuse, continue uterine massage and put the baby to the mother’s breast.

(2) Continue support of the patient’s circulation with colloid or saline by IV.

(3) Transport the patient and baby rapidly to a medical treatment facility.

(4) DO NOT examine the mother’s vagina or pack the mother’s vagina with anything.

b. External Bleeding. External bleeding may be caused by perineal tears. Manage such bleeding with pressure. If necessary, open the labia and lay packs at the bleeding site.