Background
When looking the causes of maternal death in Tajikistan’s public and private hospitals, the main reason appears to be bleeding after childbirth, also known as postpartum hemorrhage. The majority of deliveries in rural areas take place at home, under the supervision of traditional birth attendants. Most rural areas lack emergency obstetric care facilities and even highly skilled obstetricians have trouble saving lives without access to medicines and safe blood transfusion services.

About the project
This project was created to reduce the postpartum hemorrhage rate at Maternity Hospital #3 in Dushanbe, by introducing active management of third stage labour (AMTSL). This is a method where the midwife manages the final stage of labour, where the placenta is delivered, in a way which has been proved to lower the risk of excessive bleeding. The project team trained the hospital’s midwives, gynaecologists and obstetricians on how to perform AMTSL and then supported them as they implemented it as a routine in their daily work.

Results
By the end of the project, the correct use of AMTSL increased from 80% to 98,7% at Maternity Hospital #3. 2628 women gave birth vaginally during the project period. Before the project, postpartum hemorrhage occurred in 1,3% of the deliveries. After the project this number had decreased to 0,47%.

Year: 2008