Traditionally blood transfusions have been the standard treatment for severe postpartum anaemia. Recently, intravenous iron has become a widely used alternative. However, little is known on the comparative effectiveness of these two treatments, and in particular on more pregnancy specific outcomes of fatigue, depression and breastfeeding. A series of studies to assess the feasibility of undertaking a large multicentre randomised trial to answer this question is planned. This will include an observational study of current practice in New Zealand, surveys of women and clinicians’ views, and a pilot randomised trial. The overall objective is to improve health outcomes for postnatal women with severe anaemia.