Post-partum Haemorrhage (PPH) is defined as blood loss > 500ml after childbirth / or blood loss that significantly compromises the mother.
Blood loss > 500ml after birth
Visual estimation of blood loss is often underestimated. Clinical signs of poor perfusion should prompt a thorough assessment per Hypovolemic Shock CPG. Display a high degree of suspicion with frequent observations for all patients with PPH.
Consider additional resources for care of the newborn, maintain momentum in care and commence transport as soon as possible to definitive care.
Atony may be present if you fail to locate the fundus, or it feels soft.