article · African Health Sciences
Postpartum haemorrhage is a primary driver of maternal mortality, characterised by excessive blood loss following delivery. This study assessed the specific midwife-related factors that influence the management of postpartum haemorrhage in a rural hospital setting within Muranga County, Kenya. Using a cross-sectional approach, data were gathered through questionnaires completed by 85 midwives and structured observations of 71 practitioners. The findings demonstrate that midwife age, formal professional qualifications, direct clinical experience, and dedicated emergency training significantly impact care delivery. In addition, sound clinical understanding of haemorrhage prevention, accurate diagnosis, placental examination, uterine massage during the third stage of labour, and the correct administration of prophylactic uterotonic agents positively affected management. The findings establish a clear relationship between practitioner attributes, technical knowledge, and the successful handling of maternal bleeding emergencies.
Postpartum haemorrhage is a principal cause of maternal mortality during childbirth. Understanding the specific qualifications and competencies that affect how midwives manage excessive bleeding enables healthcare administrators to design targeted training interventions. Strengthening provider capabilities in rural settings can directly improve emergency obstetric care and help prevent avoidable maternal deaths.
The abstract does not indicate a commercialisation pathway, as it focuses entirely on observational clinical practice. The findings could nevertheless inform the development of targeted professional training curricula or digital clinical decision-support tools for maternal healthcare providers, though such applications remain at an early concept stage based on this baseline evidence.
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Background: Postpartum hemorrhage is the cumulative blood loss of 500 milliliters or more in a spontaneous vaginal delivery and approximately 1,000 milliliters or more for caesarean section birth and a leading cause of maternal mortality1. Objective: The overall aim of the study was to determine midwives’ factors that influence the management of PPH. Methods: A descriptive cross-sectional study that employed a quantitative approach through the use of a research self- ad- ministered questionnaire and an observational checklist targeting midwives were used. 85 midwives filled the questionnaire and 71 were observed respectively. The study was hospital- based conducted in Muranga County, Kenya. Convenience sam- pling technique was used to select the midwives in the study sites. Results: The following factors were statistically significant in influencing management of postpartum hemorrhage; age (P-value = 0.021). professional qualification ( P= 0.047), experience in management of PPH ( P= 0.032) and training on emergency PPH ( P= 0.010), knowledge factors that were found to influence the management of PPH positively include knowledge on; prevention of PPH (p value-0.000), correct use of prophylactic uterotonic agents ( P= 0.000), uterotonics use ( P= 0.043), uterine massage during 3rd stage of labour ( P= 0.012), examination of the placenta ( P= 0.034), management of PPH (P= 0.028), causes and diagnosis of PPH ( P= 0.001), (Fischer’s exact value= 0.043). Conclusion: Results of the study indicate a statistical association between midwives’ factors and management of PPH. Keywords: Midwifery factors; management of postpartum haemorrhage.
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DOI: 10.4314/ahs.v21i1.39
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