**Abstract**

What to expect after the child birth. A healthy newborn is considered as priority, but postnatal care counts too. It is not always that story ended up with safe child birth; mother is still at high risk if not taken care after birth. Antenatal and intra natal period are the hardest part of a life span of a pregnant women. Mandatory Antenatal visits and maternal and child health services provided by the government with hand holding national programs and schemes have converted this tough path into smooth platform. Similarly postnatal period is equally important in the life of a new mother. The transition has already been set up by creating fourth stage of pregnancy instead of traditional three stages. Several studies have observed complications in postnatal period especially Primary PPH but very minimal studies had concentrated on Secondary PPH. Over and above there are no significant and standardized guidelines made available for the health workers to define the set limits of blood loss and management of secondary PPH. The condition becomes more critical when severe secondary PPH came for the hospitalization when the exact cause and associated factors remains often unknown. Also many postpartum infections emerge 24 hours after the delivery and discharge from hospital. Consequently, in the lack of proper knowledge and skills regarding identification of postnatal complications like secondary PPH and Puerperal infection, many cases go undiagnosed and unreported. This chapter will deals with the skills of the ground level workers required to identify and manage selected high risk complications in postnatal period.

**Keywords:** PPH, Puerperal Infections, Knowledge, Skills, Ground level workers
