A woman develops severe postpartum hemorrhage (PPH) immediately after delivery. What is the first-line management?

Correct option is B

The first-line step in PPH management is uterine massage to stimulate uterine contraction. This is done immediately while preparing uterotonics.
Explanation of options: (a) ✘ Oxytocin is given quickly but massage is the very first bedside step. (b) ✔ Correct; uterine massage is the first immediate measure in atonic PPH. (c) ✘ Bimanual compression is used when massage/oxytocin fail. (d) ✘ Hysterectomy is last resort, not first-line.