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(Birth. 2015;42(3):235–241)Immediate postpartum hemorrhage is a common and dangerous complication for which risk factors have been established. However, there is a distinct lack of research regarding secondary postpartum hemorrhage, with only 2 studies reporting on possible risk factors. These studies found a variety of risk factors, including immediate postpartum hemorrhage, hemorrhage during pregnancy, manual removal of the placenta, a history of secondary postpartum hemorrhage, hospitalization during the third trimester, maternal smoking, and a prolonged or incomplete third stage of labor. The authors of this study sought to determine what factors might indicate an increased risk for severe secondary postpartum hemorrhage with the primary goal being to determine the association with immediate postpartum hemorrhage.