Postpartum hemorrhage (PPH) is one of the most common causes of maternal mortality worldwide including India. Uterine atony accounts for 90% of cases of postpartum hemorrhage. Postpartum hemorrhage is a dreaded third stage complication arising most commonly from uterine atony but less frequently from coagulopathy, genital tract trauma or retained placental tissues. Prevention of PPH includes general measures like correction of pre-existing anemia, routine use of partogram which helps to avoid prolonged labour, active management of third stage of labour (AMTSL), routine inspection for retained products of placenta or any genital tract trauma, prophylactic oxytocin bolus or infusion before delivery of placenta to promote uterine contractions and to improve tone. Management of PPH is by medical, mechanical and surgical methods. Medical management includes resuscitation with intravenous fluids blood and blood products and use of uterotonic (oxytocin, carboprost, methylergometrine, misoprostol). Mechanical methods include uterine massage, manual compression of uterus, intrauterine tamponade (Bakri balloon, condom catheter). Surgical measures include application of sutures in uterus (B-Lynch, Hayman sutures), uterine artery ligation and emergency hysterectomy. Routinely oxytocin is used as a prophylaxis and second line uterotonics (Carboprost, Methylergometrine, Misoprostol) are used as treatment for PPH. But second line uterotonics have significant limitation in form of cost and other associated medical conditions limiting their use. So, there is a need to search second line drugs which can be used as a preventive or treatment modality for PPH. Calcium plays an important role in uterine contractility in physiological conditions.  A number of in vitro studies have established that myometrial contractility is dependent upon extracellular calcium levels. In the setting of low or absent extracellular calcium, amplitude of myometrial contraction diminishes and oxytocin’s efficacy in inducing myometrial contraction diminishes by 60-75%. Low serum concentration of calcium affects normal uterine contractility during normal labor and PPH.  Jessica R et al, in a pilot study demonstrated that one gram of calcium chloride is significantly effective in prevention of uterine atony without any significant adverse effects of hypercalcemia. So, we hypothesize that supraphysiologic effect of calcium by administration of calcium gluconate in equivalent dose of one gram of calcium chloride is effective in prevention of uterine atony in Indian population and hence will reduce incidence of postpartum haemorrhage and need for blood transfusion without any adverse effect of significant hypercalcemia.