Identify two common risk factors for postpartum hemorrhage.

• A. Uterine atony and prolonged labor
• B. Hypertension and diabetes
• C. Preterm birth and polyhydramnios
• D. Fetal distress

Answer: (A)

Postpartum hemorrhage happens most often when the uterus doesn’t contract firmly after delivery. The tightening of the uterus is what compresses the blood vessels at the placental site; if contractions are weak or absent, bleeding continues. That failure to contract is called uterine atony, and it’s the leading cause of PPH.

Two very common factors that set the stage for this are uterine atony itself and prolonged labor. Prolonged labor fatigues and overdistends the uterine muscle, making it harder for the uterus to regain strong tone after the placenta is delivered. When the uterus is tired or overstretched, the contractions aren’t effective, and heavy bleeding ensues. In practice, recognizing prolonged labor as a risk helps explain why atony develops and underscores the importance of timely interventions to stimulate contraction and prevent hemorrhage. Other conditions like hypertension or diabetes influence pregnancy health but aren’t as directly tied to the most frequent mechanism of PPH.