Recommendation #8: When PPH occurs, the cause
of bleeding should be identified and directed
treatment undertaken promptly. (III)
Prompt decision making and communication are the
cornerstones of management of PPH.62 Informing the
woman, her partner and other health care providers
assisting the midwife of the situation initially and in an
ongoing manner is an important aspect of management.
Recommendation #9: In addition to controlling
bleeding, the initial steps in treatment of PPH
include treating shock and communicating with the
client and other health care providers assisting the
midwife. (III)
Options for treatment of PPH include drugs to increase
uterine contraction and surgical techniques.61 Treatment
is directed based on the identification of the cause of
hemorrhage. The most common cause of PPH is uterine
atony which can be treated by uterine massage and/or