Naomi has had 6 pregnancies, 4 live children, her last baby was born dead. She lives in a remote Maasai Village where all of her previous deliveries had occurred. She was presented to Kivulini, in false labour with baby number 6. Today, That same evening, Naomi was in active labour and progressed to a normal birth of a live baby girl. 30 minutes after Naomi delivered she started to bleed heavily. Bleeding post delivery is the major cause of maternal deaths in developing countries. She was assessed and found to have lost 800mls. Active management of PPH postpartum haemorrhage was commenced, a 400mls blood clot was expelled, emergency medications given and bleeding ceased. When Naomi was asked what Kivulini has meant to her, she commented: “ Me think I die if I not come to Kivulini.”
what was the causative of that bleeding.