Secondary postpartum hemorrhage requiring IV antibiotics
Retained products requiring procedure
Significant anemia requiring transfusion
Observation pathway
Observation appropriate features
Bleeding controlled
Stable vitals for at least 4 to 6 hours
Discharge criteria
Discharge requirements
Bleeding minimal and stable
Hemoglobin stable and symptoms resolved
Reliable follow up and return precautions understood
Transfer criteria
Transfer indications
Need for interventional radiology not available
Need for surgical capability not available
Discharge Instructions
Copy discharge instructions
Postpartum bleeding visit summary
Heavy bleeding has stopped or improved and your vital signs are stable
Some bleeding or spotting can be normal after delivery but heavy bleeding is not
Medications
Take medications exactly as prescribed
Avoid aspirin or NSAIDs unless your clinician told you to take them
Activity
Avoid heavy lifting until cleared by your obstetric clinician
Rest and hydrate
Follow up
Obstetric follow up within 24 to 72 hours if bleeding was significant
Earlier follow up if anemia symptoms occur
Return to emergency care immediately for
Soaking 1 pad in less than 1 hour
Passing large clots
Dizziness or fainting
Chest pain or trouble breathing
Fever
Worsening abdominal or pelvic pain
References
Guidelines and key sources
Evidence based references
American College of Obstetricians and Gynecologists postpartum hemorrhage practice guidance
World Health Organization recommendations for prevention and treatment of postpartum hemorrhage
International Federation of Gynecology and Obstetrics postpartum hemorrhage guidance
Royal College of Obstetricians and Gynaecologists postpartum hemorrhage guideline
WOMAN Trial tranexamic acid in postpartum hemorrhage
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.