Postpartum hemorrhage (PPH) has four primary causes: 1. Lacerations from difficult labor; 2. Placental factors; 3. Uterine atony; 4. Coagulopathy. Immediately after childbirth, if there is bright red bleeding that includes blood clots, this is considered to be caused by soft birth canal lacerations. Approximately 10 to 15 minutes after delivery of the fetus, if significant bleeding occurs, placental factors should be considered. After the placenta is delivered, if the placenta and membranes are found to be intact and there is still vaginal bleeding, or if there is intermittent heavy vaginal bleeding, and the uterus feels soft and poorly defined upon light palpation, uterine atony should be considered as a likely cause of the heavy bleeding. Lastly, coagulopathy, which leads to continuous, dark red bleeding without clots, can also cause severe postpartum hemorrhage.