Obstetrical routines at the third stage of labour in a delivery unit in Jimma, Ethiopia – WANT study

Abstract

ABSTRACT Background: Ethiopia has one of the highest maternal mortality rates in the world. The major cause of maternal deaths is postpartum haemorrhage. Active management of the third stage of labour reduces this risk. Late cord clamping and cutting may improve the neonatal outcomes. We aimed to assess whether the clinical routines at Jimma University Specialized Hospital in Ethiopia follow international recommendations regarding management of the third stage of labour. Methods: Our design was, in combination with a literature review, an observational study which was performed as a cross-sectional study during the period January 29th 2014 to February 12th 2014. Case report forms were used to collect data from a convenience sample and the results were analyzed in SPSS. Results: We collected data from 87 women in labour and observed a total of 56 births. All women received oxytocin immediately after birth, controlled cord traction and uterine massage were performed. Early cord clamping was routinely practiced. Conclusion: Controlled cord traction only gives a small reduction in blood loss postpartum, however, continuing this practice can still be beneficial for the mother. The limited access to operating theatres and the lack of access to blood transfusions make it even more essential. Early cord clamping is not in accordance with the WHO recommendations. Delayed cord clamping increases iron stores, haematocrit and haemoglobin concentrations in both full term and preterm infants and is a cost free and easy way of improving newborn health.