"How much blood have you passed?" (Quantity, e.g., "soaking pads," "passing clots the size of a lemon/golf ball"). Reasoning: Helps estimate blood loss.

"Are you feeling dizzy, lightheaded, or weak?" Reasoning: Symptoms of hypovolemia (low blood volume) and anemia (low red blood cell count) due to blood loss.

"Do you have any pain? Where is it?" Reasoning: Severe pain might indicate uterine rupture, large hematoma, or retained tissue. Atony is often painless.

"Are you passing clots? What size?" Reasoning: Large clots suggest significant ongoing bleeding and poor uterine contraction (atony) or retained tissue.

Obstetric History:

Gravidity and Parity: "How many pregnancies have you had (gravida) and how many live births (para)?" Reasoning: High parity increases risk of uterine atony.
Previous PPH: "Did you have heavy bleeding after your previous deliveries?" Reasoning: History of PPH is a strong predictor for recurrence.
Previous C-sections or uterine surgeries: "Have you had any previous C-sections or other surgeries on your uterus?" Reasoning: Increases risk of placenta accreta spectrum and uterine rupture.

Current Pregnancy and Labor History:

Antenatal complications: "Were there any issues during this pregnancy, like high blood pressure (pre-eclampsia), gestational diabetes, or bleeding?" Reasoning: Pre-eclampsia can lead to HELLP and coagulopathy. Placenta previa/abruption are risk factors.
Type of delivery: "Was it a vaginal birth or C-section? Was it assisted (forceps/vacuum)?" Reasoning: C-section increases blood loss. Instrumental delivery increases risk of trauma.
Duration of labor: "How long was your labor?" Reasoning: Prolonged or precipitous labor increases risk of atony.
Size of baby/multiples/fluid: "Was your baby very large? Did you have twins or triplets? Were you told you had too much amniotic fluid?" Reasoning: Overdistension risks atony.
Placental delivery: "Did the placenta come out easily and completely? Was it inspected?" Reasoning: Retained tissue is a major cause.
Medications during labor: "Did you receive any medications like magnesium sulfate or general anesthesia?" Reasoning: Can cause atony.

Medical History:

Bleeding disorders: "Do you or anyone in your family have a history of bleeding disorders (e.g., easy bruising, nosebleeds, prolonged bleeding after cuts/surgery)?" Reasoning: Suggests pre-existing coagulopathy.
Other chronic conditions: "Do you have any other medical conditions, like liver disease or kidney disease?" Reasoning: Liver disease can impair clotting factor production.
Medications: "Are you on any blood thinners or other regular medications?" Reasoning: Anticoagulants increase bleeding risk.

Signs of Postpartum Hemorrhage (Objective Information)

These are what the healthcare provider observes and measures.

Visible Blood Loss:
- Observation: Soaked perineal pads, blood pooling under the buttocks, large clots. Reasoning: Direct evidence of bleeding. Visual estimation is often inaccurate and underestimates actual loss.
Uterine Assessment:
- Palpation: A boggy (soft, poorly contracted) and enlarged uterus felt on abdominal examination. Reasoning: Classic sign of uterine atony. A well-contracted uterus should feel firm and be