The correct answer is D. applying direct pressure.

A perineal tear after childbirth is a form of external soft-tissue bleeding. The primary prehospital treatment for any external bleeding, including obstetric perineal tears, is direct pressure with sterile dressings.

According to NREMT EMT-level obstetrics care guidelines, bleeding control in the postpartum patient should follow standard hemorrhage control principles, with emphasis on direct pressure as the first-line intervention.

Why D is correct:

Direct pressure is the most effective and immediate method to control bleeding from a perineal tear.

It helps reduce blood loss and prevents further complications such as shock.

Why the other options are incorrect:

A. Packing her vagina with gauze → This is not appropriate in the prehospital setting and may cause further injury or infection.

B. Elevating her pelvis → Not a recognized or effective method for controlling perineal bleeding.

C. Having her keep her legs flexed → This does not control bleeding and has no role in treatment.

Exact Extracts:

“Control external bleeding with direct pressure using sterile dressings.”

“Postpartum bleeding should be managed with standard hemorrhage control techniques.”

“Direct pressure is the first step in controlling soft-tissue hemorrhage.”