title: Knowledge of blood loss at delivery among postpartum patients.
abstract: BACKGROUND
  Postpartum hemorrhage (PPH) is a leading cause of obstetric morbidity. There is limited understanding of patients' knowledge about blood loss at delivery, PPH, and PPH-related morbidities, including transfusion and anemia.
  
  
  METHODS
  We surveyed 100 healthy postpartum patients who underwent vaginal or cesarean delivery about blood loss, and whether they received information about transfusion and peripartum hemoglobin (Hb) testing. Responses were compared between women undergoing vaginal delivery vs. cesarean delivery; P < 0.05 considered as statistically significant.
  
  
  RESULTS
  In our cohort, 49 women underwent vaginal delivery and 51 women underwent cesarean delivery. Only 29 (29%) of women provided blood loss estimates for their delivery. Women who underwent cesarean delivery were more likely to receive clear information about transfusion therapy than those undergoing vaginal delivery (43.1% vs. 20.4% respectively; P = 0.04). Women who underwent vaginal delivery were more likely to receive results of postpartum Hb tests compared to those undergoing cesarean delivery (49% vs. 29.4%; P = 0.02).
  
  
  CONCLUSIONS
  Our findings suggest that women are poorly informed about the magnitude of blood loss at delivery. Hematologic information given to patients varies according to mode of delivery. Further research is needed to better understand the clinical implications of patients' knowledge gaps about PPH, transfusion and postpartum anemia.
authors.affiliation: Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School , Boston , United States.
authors.forename: Michaela K
authors.initials: MK
authors.lastname: Farber
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine , Stanford , CA , United States.
authors.forename: Claire M
authors.initials: CM
authors.lastname: Miller
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine , Stanford , CA , United States.
authors.forename: Bharathi
authors.initials: B
authors.lastname: Ramachandran
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine , Stanford , CA , United States.
authors.forename: Priya
authors.initials: P
authors.lastname: Hegde
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine , Stanford , CA , United States.
authors.forename: Kulsum
authors.initials: K
authors.lastname: Akbar
authors.affiliation: Departments of Pathology and Medicine, Stanford University School of Medicine , Stanford , CA , United States.
authors.forename: Lawrence Tim
authors.initials: LT
authors.lastname: Goodnough
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine , Stanford , CA , United States.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Butwick
keywords: Anemia; Estimated blood loss; Patient knowledge; Postpartum hemorrhage