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To explore how childbirth-related blood loss is evaluated and excessive bleeding recognised; and to develop and test a theory of postpartum haemorrhage (PPH) diagnosis. Two-phase, exploratory, sequential mixed methods design using focus groups, interviews and a pilot, randomised crossover study. Two hospitals in North West England. Women (following vaginal birth with and without PPH), birth partners, midwives and obstetricians. Phase 1 (qualitative) 8 focus groups and 20 one-to-one, semi-structured interviews were conducted with