Background. Uterine balloon tamponade (UBT) is used as part of the post partum haemorrhage (PPH) algorithm for the treatment of PPH. Objectives. The free-flow Ellavi uterine balloon controls the pressure in the uterine balloon by adjusting the height of the supply bag above the patient and allows for expulsion of water from the balloon. The study quantified the volume shifts in the supply bag and assessed the optimal use of the Ellavi UBT by reducing the intrauterine pressure at regular intervals. Methods. A prospective descriptive study of consecutive patients with refractory PPH was conducted. For group A, the supply bag was weighed every 30 minutes with a sensitive digital scale. Additionally, for group B the supply bag was lowered by 50% and the uterus gently massaged for 30 seconds.Results. Thirteen patients were included in the study. The mean volume was 23.5 mL for Group A and 132.7 mL for Group B. The difference in the means of groups A and B was borderline significant (p=0.06). Conclusion. The study did find volume shifts in the free-flow system, which may be enhanced by lowering the supply bag halfway at regular intervals.