Factors that influence management of postpartum hemorrhage among midwives in a rural setting in Kenya

Abstract

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.