Knowledge of Strategies Used in the Management and Prevention of Postpartum Haemorrhage Among Midwives at Mulago National Referral Hospital.

Abstract

The study examined the knowledge of strategies used in the management and prevention of postpartum hemorrhage among midwives at Mulago National Referral Hospital. The purpose of the study was to assess midwives knowledge of strategies used in prevention and management of postpartum hemorrhage. This was descriptive cross-sectional study design in which quantitative methods were used to collect data. The study population consisted of all midwives currently working in the selected hospital at the time of the study. This population was chosen because midwives were first point of contact for women during labour and normal labors are managed by midwives. The instrument used for data collection was a self-structured questionnaire to suit the purpose of the study. Data collected was analyzed and results presented using descriptive statistics in form of percentages and frequency tables. Findings from the study indicated that majority of the respondents had managed PPH and knew the risk factors and strategies used in prevention and control of PPH. The percentage of participants who knew the strategies used in the prevention and management of PPH indicated high level of knowledge. Among the strategies identified in the prevention and management of PPH include; early cord clamping, bladder emptying, placing the woman in a trendeleburg position, uterine massage after delivery of the placenta and the use of uterotonics with oxytocin being the most commonly used. It was concluded that the midwives in Mulago National Referral Hospital have high level of knowledge of strategies used in the prevention and management of PPH. It is therefore recommended that strategies involved in the prevention and management of PPH are clearly documented and midwives must keep abreast with these strategies and implement them in all health care settings in order to reduce the risk of PPH which is a leading cause of maternal morbidity and mortality worldwide. It is also recommended that identification of risk factors for PPH should occur in an ongoing manner throughout the course of care, refresher courses where nurse-midwives and other health care professional should be trained and retrained on the strategies used in the prevention and management of PPH which should be periodically organized, active management should be offered to all pregnant women, active management is strongly recommended for women with an identified increased risk of postpartum hemorrhage, there should be access to previous obstetrical records and continuing evaluation of risk factors which will help midwives to identify women to whom active management should be recommended and that midwives should endeavor to minimize any existing barriers to the implementation of active management.