Midwives Practice in Active Management of Third Stage of Labor in Omudruman State Hospitals- Sudan 2016

Abstract

ABSTRACT

Background

Postpartum hemorrhage is one of the leading causes of maternal death worldwide; it occurs in about 10.5% of births and accounts for over 130,000 maternal deaths annually1.Active management of the third stage labor is a feasible and inexpensive intervention that helps saving thousands of women’s lives of labor (AMTSL) includes administration of uterotonic drug, controlled cord traction and uterine massage after delivery of placenta. The AMTSL guidelines were introduced in 2003, modified in 2006, and has been part of the national guidelines in Sudan since 2009.

Objective

The aim of the study was to evaluate midwives practice in the Active management of third stage of labor in Omudruman state Hospitals.

Methods

This is a descriptive cross sectional hospital based study conducted on total coverage of 50 midwives and 45 women who underwent normal vaginal delivery during the study period. Data was collected using individual instructed questionnaire to assess midwives practice towards the active management of third stage of labor and observational checklist to observe delivering women during the third stage of labor and to assess the midwives implementation of the active management of third stage of labor.

Results

Use of uterotonic drug during the third stage of labor was nearly universal. Correct use of active management of the third stage of labor was found in only 26.7% of observed deliveries due to multiple deficiencies in practice, policies regarding active management of third stage of labor were. The association between approach in delivering of the placenta and timing of administration of usual dose of oxytocin was significant. Midwives experience in years greatly influenced the method of placenta delivery.

Conclusion and recommendation

The implementation of active management of third stage of labor is ineffective. Studies are needed to identify the most effective components of active management so that the most efficient package of practices can be promoted.

Keywords:

Oxytocin, Controlled cord traction, Uterine massage and Active management of third stage of labor.