Abstract
Introduction Globally, postpartum hemorrhage is the most common cause of maternal mortality and morbidity, and it accounts for more than 25% of all maternal deaths. The majority of death due to postpartum hemorrhage is caused by uterine atony. Routine and correct usage of active management of the third stage of labor decreases the occurrence of postpartum hemorrhage by 60% when compared to expectant management of the third stage of labor. The purpose of this study was to assess midwife knowledge, practice, and associated factors towards active management of the third stage of labor at governmental health institutions in the Tigray region, 2018. Results These study results showed that from the total study participants (N = 278), 170 (61.2%) were good in knowledge and 121 (43.5%) were good in practice towards active management of the third stage of labor. Training related to active management of the third stage of labor (AOR = 2.119, 95%CI = 1.141, 3.3937) and practice level of midwives (AOR = 8.089, 95%CI = 4.103, 15.950) became significantly associated with the knowledge level. The educational level of midwives (AOR = 3.811, 95%CI = 2.015, 7.210), training related to active management of the third stage of labor (AOR = 2.591, 95%CI = 1.424, 4.714), and knowledge level of midwives towards active management of the third stage of labor (AOR = 7.324, 95%CI = 3.739, 14.393) were significantly associated with the practice level. This study showed that training related to active management of the third stage of labor was significantly associated with the knowledge and practice level of midwives. The educational level and knowledge level of midwives were significantly associated with the practice level of midwives towards active management of the third stage of labor. Therefore, midwives should update their academic level and knowledge. Health institutions in collaboration with the Tigray Regional Health Bureau should arrange training for all midwives to bring change.
Highlights
Postpartum hemorrhage is the most common cause of maternal mortality and morbidity, and it accounts for more than 25% of all maternal deaths
Little has been known about midwife knowledge, practice, and associated factors towards active management of the third stage of labor in our country, and no study is conducted in the current study area, so this study was aimed at finding out midwife knowledge, practice, and associated factors towards active management of the third stage of labor in the Tigray region
61.20% All of the third stage of labor were 61.2% and 43.5%, respectively. This finding is in line with the study conducted in Nigeria and Ethiopia, Addis Ababa, which showed that the overall knowledge and practice of midwives towards AMTSL were 66.7%, 41.7% and 51.5%, 47%, respectively [21, 22]. This might be due to the similarity in sociodemographic status of study participants in which midwives from both health center and hospitals were included in the study but higher than the study conducted in Ethiopia, Hawassa, and study conducted in Sudan which showed that 33.3%, 16.7% and 15.6%, 26.7% of study participants were good in knowledge and good in practice, respectively [16, 17]
Summary
Postpartum hemorrhage is the most common cause of maternal mortality and morbidity, and it accounts for more than 25% of all maternal deaths. Training related to active management of the third stage of labor (AOR = 2:119, 95%CI = 1:141, 3.3937) and practice level of midwives (AOR = 8:089, 95%CI = 4:103, 15.950) became significantly associated with the knowledge level. The educational level of midwives (AOR = 3:811, 95%CI = 2:015, 7.210), training related to active management of the third stage of labor (AOR = 2:591, 95%CI = 1:424, 4.714), and knowledge level of midwives towards active management of the third stage of labor (AOR = 7:324, 95%CI = 3:739, 14.393) were significantly associated with the practice level. This study showed that training related to active management of the third stage of labor was significantly associated with the knowledge and practice level of midwives. The fourth stage is the stage of labor that extends to one hour after delivery of the placenta [1]
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