ABSTRACT Aim To investigate the associations between primary postpartum haemorrhage (PPH), postnatal mental health and longer-term mental illness in a high-income setting. Methods A population-based retrospective cohort study of 18,798 women giving birth between 2008 and 2016 in Grampian, Scotland, was conducted, using linked data from the Aberdeen Maternity and Neonatal Databank and Scottish administrative healthcare datasets.