Postpartum hemorrhage management includes which step?

• A. Administer antibiotics.
• B. Continue uterine massage.
• C. Pack dressings into the vagina.
• D. Withhold Pitocin.

Answer: (B)

The key idea is to restore and maintain uterine tone to stop bleeding. Postpartum hemorrhage is most often caused by uterine atony, where the uterus doesn’t contract well enough to compress bleeding from the placental site. Continuous uterine massage directly stimulates contractions and helps the uterus clamp down, which reduces hemorrhage while other treatments are started.

Antibiotics are important for infection risk but don’t acutely stop hemorrhage. Packing the vagina isn’t a first-line step in initial management and can delay more effective measures. Withholding Pitocin would remove a primary drug that promotes contraction; uterotonics are essential, and massage works alongside them to optimize uterine tone. So, continuing uterine massage is the best immediate step.