FOI 26-308 Secondary Postpartum Haemorrhage
Freedom of Information Request
- Reference
- FOI 26-308 Secondary Postpartum Haemorrhage
- Request Date
- 10 Jul 2026
- Response Date
- 05 Aug 2026
- Information Requested
, I request the following information:
- Clinical training guidance
Copies of any anonymised case studies, learning materials, clinical updates, or training modules developed and distributed to Advanced Paramedics, Advanced Practitioners, Emergency Medical Dispatchers, or other relevant clinical staff from August 2021 onwards regarding:
- the triage and prioritisation of secondary/late postpartum haemorrhage;
- risk assessment and management of significant postpartum bleeding;
- decision-making around emergency response versus alternative pathways, including clinical callback systems.
- Protocols, guidance, and operational changes
Copies of any internal clinical guidance, clinical memos, dispatch guidance, or amended protocols issued to ambulance control centres from August 2021 onwards relating specifically to patients presenting with heavy postpartum bleeding following caesarean section, including any changes regarding:
- prioritisation of a face-to-face emergency ambulance response;
- use of clinical callback pathways;
- escalation criteria, risk categorisation, or dispatch decision-making.
- Implementation and review information
The date on which any changes relating to the triage, prioritisation, or management of secondary postpartum haemorrhage presentations were formally incorporated into Scottish Ambulance Service operational guidance or standard practice.
In addition, I request details of any formal review, audit, governance process, learning review, or service improvement action undertaken from August 2021 onwards in relation to the emergency call handling and triage of secondary postpartum haemorrhage presentations. If the information requested above is not held in the exact format described, I would be grateful if you could provide the closest available information held.
- Response
While the Scottish Ambulance Service holds a range of clinical guidance relating to obstetric and maternity emergencies, it does not categorise clinical guidance, training materials, reviews or audits by reference to "secondary postpartum haemorrhage" in a way that allows all relevant information to be readily identified. We have therefore interpreted your request as seeking records specifically created or amended in relation to secondary postpartum haemorrhage presentations and have provided the information located following reasonable and proportionate searches.
Q1 - The Scottish Ambulance Service does not develop or deliver Emergency Medical Dispatcher training materials relating to the Medical Priority Dispatch System (MPDS). Training and certification are provided by the International Academies of Emergency Dispatch (IAED). The Service does not hold SAS-developed training modules, case studies or learning materials specifically relating to secondary postpartum haemorrhage. Therefore, in terms of section 17(1) of FOISA, we do not hold information falling within this part of your request.
Q2 - The Scottish Ambulance Service utilises the Medical Priority Dispatch System (MPDS) to support the assessment and prioritisation of emergency 999 calls. Through a structured questioning process, call handlers gather information from callers and enter this into the MPDS system. The categorisation and prioritisation of calls is determined by pre-defined clinical protocols and determinants within the system, based on the information provided by the caller, rather than on the individual call handler's interpretation or personal clinical knowledge.
In November 2016, the Scottish Ambulance Service implemented the Clinical Response Model (CRM) for emergency 999 calls. The CRM aims to ensure patients receive the most appropriate response based on clinical need by more accurately identifying those with immediately life-threatening conditions and matching resources accordingly.
Where information provided by a caller during the MPDS triage process indicates a presentation consistent with secondary postpartum haemorrhage, the relevant protocol within the system assigns a Red response category. A Red response results in an immediate face-to-face ambulance response being dispatched.
It should be noted that categorisation is dependent upon the information available to and provided by the caller at the time of the 999 call. Different information or symptoms presented during the call may result in a different categorisation and response being assigned.
Beyond the application of the Clinical Response Model and MPDS protocols, the Scottish Ambulance Service has not identified any additional local guidance, clinical memos, dispatch guidance or amended protocols specifically relating to secondary postpartum haemorrhage during the period requested.
Q3 - Following searches of the information held by the Scottish Ambulance Service, we have been unable to identify recorded information confirming when any specific changes relating to the triage, prioritisation or management of secondary postpartum haemorrhage were formally incorporated into operational guidance. Therefore, in terms of section 17(1) of FOISA, this information is not held.
The Scottish Ambulance Service has not identified any formal review, audit, governance process, learning review or service improvement action specifically relating to the emergency call handling and triage of secondary postpartum haemorrhage presentations during the period requested. Therefore, in terms of section 17(1) of FOISA, this information is not held.
