02/25/2026
EBL training with community midwives! Thank you and
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Let’s talk about bleeding after birth. Midwives are trained in both estimated blood loss (EBL) and quantitative blood loss (QBL). What is the difference?
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Estimated Blood Loss (EBL)
What it is:
-A visual approximation of how much blood a mom has lost.
How it’s done:
-Midwife visually assesses blood on:
-Chux pads
-Towels/linens
-Birth pool water
-Floor or surrounding surfaces
-Clot size is visually estimated
-Experience-based judgment
Pros:
-Fast
-No equipment required
-Practical for home settings
Cons:
-Often underestimates blood loss by 30–50%
-Amniotic fluid mixed with blood makes estimation difficult
-Can delay recognition of postpartum hemorrhage (PPH)
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Quantitative Blood Loss (QBL)
What it is:
-A measured calculation of actual blood loss using weight and/or volume.
How it’s done in home birth:
-Weigh soaked materials (1 gram = 1 mL blood)
Pros:
-More accurate
-Detects hemorrhage earlier
-Increasingly considered best practice
Cons:
-Requires scale and setup
-More time-consuming
-Harder with water births (blood dilution)
Why This Matters in Home Birth
Postpartum Hemorrhage (PPH)
Defined as:
≥500 mL after vaginal birth
≥1000 mL considered severe
“Organizations such as the American College of Obstetricians and Gynecologists and World Health Organizationrecommend quantitative measurement when possible because visual estimation frequently delays recognition of PPH.”
