Abstract: Objective To explore the risk factors and nursing strategies for postpartum hemorrhage in elderly primipara so as to reduce the incidence of postpartum hemorrhage.Methods A total of 85 elderly primipara with postpartum hemorrhage from June 2017 to June 2018 were selected as the research group, while 125 cases elderly primipara without postpartum hemorrhage were collected as the control group. The correlative risk factors of postpartum hemorrhage were analyzed by univariate and multivariate logistic analysis.Results History of abortion, complications of pregnancy, placental abnormality, macrosomia, cesarean section, uterine inertia, prenatal coagulation dysfunction, and soft birth canal laceration were the risk factors for postpartum hemorrhage in elderly primipara.The multiple logistic regression analysis indicated that uterine inertia, placental abnormality and complications of pregnancy were the independent risk factors for postpartum hemorrhage in elderly primipara.Conclusion The main risk factors for postpartum hemorrhage in elderly primipara might be uterine inertia, placental abnormality and complications of pregnancy. And it is necessary to take nursing intervention strategies in response to the risk factors so as to reduce the incidence of postpartum hemorrhage.