A potentially prolonged labor induction with prolonged use of oxytocin and magnesium sulfate, along with the inability to use methergine as a primary uterotonic due to its contraindication in patients with hypertensive disease, increases the likelihood that Black women with GDM, obesity, and preeclampsia will likely experience uterine atony with PPH, requiring administration of blood products, particularly during a cesarean birth. This evidence concerns the gene OXT and pulmonary arterial hypertension.