Acceptability, Appropriateness and Feasibility of a Calibrated Obstetric Blood Collection Drape for Postpartum Haemorrhage Detection: A Qualitative Study in Two Tertiary-Care hospitals in Delhi, India

ABSTRACT Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality globally. Accurate and objective blood loss measurement is essential for timely detection and management of PPH. However, visual estimation remains the predominant method of blood loss estimation in low- and middle-income country settings, despite it underestimating blood loss by 33-50%. In this context, a calibrated obstetric blood collection drape offers a practical, low-cost alternative. However, Evidence on acceptability, appropriateness and feasibility remains limited. Objective: To explore the facilitators and barriers to the acceptability, appropriateness and feasibility of the routine implementation of a calibrated obstetric blood collection drape for postpartum haemorrhage (PPH) detection in two tertiary-care hospitals in Delhi, India. Methods: This qualitative study used semi-structured interviews to explore healthcare providers' experiences and perceptions regarding the acceptability, appropriateness and feasibility of using the drape in routine labour room practice. Qualitative data were analysed using thematic analysis. Results: Eighteen healthcare providers participated in qualitative interviews. The calibrated drape was perceived as more reliable than visual estimation and easy to use, supporting confidence, quicker responses and clinical decision-making. It was also considered useful for early PPH detection and timely management. Key challenges included staff shortages and concerns about drape slipperiness and fastening mechanisms. Conclusions: Findings suggest that the calibrated obstetric blood collection drape is perceived as acceptable, appropriate and feasible for routine use in high-volume tertiary-care hospitals in India. Wider implementation will require reliable supply chains, design refinements, and sustained training programmes, including for support staff.