Amos Getanda


Introduction: Evidence indicates active management of third stage of labour (AMTSL) in preventing PPH due to uterine atony. However, often the management of third stage of labour is in different forms in different providers, settings and circumstances. This study was aimed at establishing how the midwives in a national referral hospital in Kenya manage third stage among mothers undergoing normal labour.


Methods: Twenty eight (28) midwives in the hospital were observed while managing third stage of labour using a structured checklist. The data was analysed using SPSS 12.0.


Findings:   All the mothers were given oxytocin for the management of third stage although some (14.3%) was given after 2-5 minutes of birth. Cord traction with counter-traction was observed in 25 (92.6%) of the midwives. However, cord traction was done after realization of signs of placental separation in 15 (55.6%) of the cases.


Conclusion and Recommendations: Midwives should be trained on AMSTL in order to ensure that this practice is properly implemented. There should also be continuous monitoring and evaluation of the practice.


active management; third stage; labour; midwives; kenya

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