Prolonged Field Care Podcast

Prolonged Field Care Podcast 245: Postpartum Hemorrhage

Sep 1, 2025
Jessica, known as the Combat Midwife, is a paramedic and midwife with expertise in maternal-child care. In this engaging conversation, she discusses critical issues surrounding postpartum hemorrhage, highlighting its status as a leading cause of maternal death. Jessica breaks down the mismanagement of obstetrics, emphasizes the importance of understanding the natural process of birth, and shares practical tips for effective labor management. She also introduces her Emergency OB Kit and valuable educational resources for improving maternal care.
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ANECDOTE

Interventions Create Cascading Problems

  • Jessica compares micromanaging birth to micromanaging breathing to show its harm.
  • She uses a Hegelian dialect example: interventions create new problems requiring more interventions.
ADVICE

Assess The Four T's First

  • Recognize the four causes of postpartum hemorrhage: tone, tissue, trauma, and thrombin.
  • Prioritize restoring uterine tone first because overdose or forced acceleration of labor often causes atony.
ADVICE

Use Positioning To Encourage Placenta

  • If placenta seems retained, reposition mom: stand, squat, or have her move to dislodge fragments.
  • Ask her to find the fundus, massage it, and use gravity/positioning before invasive removal.
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