Use of active management of the third stage of labour in seven developing countries

Cynthia Stanton, Deborah Armbruster, Rod Knight, Iwan Ariawan, Sourou Gbangbade, Ashebir Getachew, Jose Angel Portillo, Douglas Jarquin, Flor Marin, Sayoka Mfinanga, Jesus Vallecillo, Hope Johnson, David Sintasath

Research output: Contribution to journalArticle

Abstract

Objective To document the use of active management of the third stage of labour for preventing postpartum haemorrhage and to explore factors associated with such use in seven developing countries. Methods Nationally representative samples of facility-based deliveries were selected and observed to determine the use of active management of the third stage of labour and associated factors. Policies on active management were assessed through document review and interviews with relevant professionals. Findings Use of a uterotonic during the third or fourth stages of labour was nearly universal. Correct use of active management of the third stage of labour was found in only 0.5% to 32% of observed deliveries due to multiple deficiencies in practice. In every country except Indonesia, policies regarding active management were conflicting. Conclusion Developing countries have not targeted decreasing postpartum haemorrhage as an achievable goal; there is little use of active management of the third stage of labour, and policies regarding such management often conflict. Studies are needed to identify the most effective components of active management so that the most efficient package of practices can be promoted.

Original languageEnglish (US)
Pages (from-to)207-215
Number of pages9
JournalBulletin of the World Health Organization
Volume87
Issue number3
DOIs
StatePublished - Mar 1 2009

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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    Stanton, C., Armbruster, D., Knight, R., Ariawan, I., Gbangbade, S., Getachew, A., Portillo, J. A., Jarquin, D., Marin, F., Mfinanga, S., Vallecillo, J., Johnson, H., & Sintasath, D. (2009). Use of active management of the third stage of labour in seven developing countries. Bulletin of the World Health Organization, 87(3), 207-215. https://doi.org/10.2471/BLT.08.052597