Causes of bleeding include placenta abruption (placental separation from implantation site before delivery), placenta previa (placenta implanted over or very near internal cervical os), prolonged third stage, uterine atony after delivery, and uterine inversion (Cunningham et al., 2013e). Risk factors for placenta abruption include increased age and parity, preeclampsia, chronic hypertension, preterm ruptured membranes, multifetal gestation, low birth weight, hydramnios, cigarette smoking, thrombophilias, cocaine use, prior abruption, and uterine leiomyoma. Maternal age, multiparity, prior cesarean delivery, smoking, and unexplained elevated screening levels of maternal serum alpha-fetoprotein (MSAFP) increase the risk for placenta previa. Management of the bleeding varies with the source of bleeding. Emergent cesarean delivery may be necessary in some cases of preterm bleeding; bleeding after delivery may require uterine massage, uterotonic agents such as oxytocin, methergine, and/or prostaglandins, removal of retained placenta, or surgical intervention depending on the cause and status of the mother.