by Sapkal Rekha
The labor is the vital landmark in the woman’s life. In India PPH as a complication of labor, disproportionately affects young, poor and other socially excluded groups of women. The Indian scenario of intractable postpartum hemorrhage is different in the labor room. Management of the lady at the doorstep of death is a skill. Her life has to be preserved at any cost. Hence there should be some planned strategy in advance. Once mishap occurs obstetricians are insecure about future of the family of the lady and their own future of practice of obstetrics. People demand justice without understanding the circumstances is the other issue. In short, it is not advanced learning it is the basic learning, surgical skills to be attempted should be highly relevant for managing the dreadful complications .It will provide confidence and skills of service provider. Decision about ligation of anterior division of internal iliac artery hits at the root.