Contraction of the uterine muscles during labor compresses the blood vessels and slows flow, which helps prevent hemorrhage and facilitates coagulation.

In addition, preeclampsia can lead to blood disorders such as thrombocytopenia, platelet abnormalities, and disseminated intravascular coagulation.

[7] After labor it is the contraction of these muscles that physically squeeze the blood vessels so that hemostasis can occur after the delivery of the fetus and the placenta.

[12] This allows for planning and organizing the necessary resources including staff, medicines, assistive devices, and the proper blood products.

The delivery plan should also be cognizant of the ability of the hospital or facility to provide an appropriate level of care if any complications occur.

If the atony is localized to one area of the uterus, the upper, fundal region may still be squeezing while the lower uterine segment is non-functional.

[1] Expulsion of gestational products such as the placenta and rapid identification of obstetric lacerations, helps exclude other causes of PPH.

It is theorized, the massaging motion stimulates uterine contraction and may also trigger the release of local prostaglandins to help hemostasis.

[1] An intravenous catheter should also be started to administer fluids, medications, and blood products[18] There are several different types of uterotonic drugs that may be given, and the each has its own advantages and disadvantages.

If the bleeding has not stopped or physical exam does not show signs of restored uterine function within 30 minutes of medication administration, immediate invasive interventions are recommended.

[27][1] Tamponade techniques include uterine packing (extending into the vagina) with gauze that also has a Foley catheter in place to allow for bladder drainage.

[28] A bakri balloon to tamponade (also with vaginal packing) can be used with Foley catheter insertion to facilitate bladder drainage.

Poor nutritional status, lack of healthcare access, and limited blood product supply are additional factors that increase morbidity and mortality.

In most cases of uterine atony-related postpartum hemorrhage, the amount of iron lost is not fully replaced by the transfused blood.