Poster: Active Management of the Third Stage of Labor (AMTSL)
Fact Sheet: Active Management of the Third Stage of Labor for Prevention of Postpartum Hemorrhage: A Fact Sheet for Policy Makers and Program Managers
Uterotonics Supply Management Cycle (Management Sciences for Health/Rational Phamaceutical Management Plus)
Download/view (59 KB PDF)
Uterotonics for the Active Management of the Third Stage of Labor (Management Sciences for Health/Rational Phamaceutical Management Plus)
Download/view (97 KB PDF)
Oxytocin in Active Management of the Third Stage of Labor (Management Sciences for Health/Rational Phamaceutical Management Plus)
Download/view (96 KB PDF)
Prevention of Postpartum Hemorrhage Initiative (POPPHI)
Saving Women’s Lives: Prevention of Postpartum Hemorrhage
NEW Joint Statement: Prevention and Treatment of Post-partum Haemorrhage New Advances for Low-Resource Settings
Press release (97 KB PDF)
Declaration of support for FIGO/ICM Global Effort to Prevent Post-partum Haemorrhage
Joint Statement: Management of the Third Stage of Labour to Prevent Post-partum Haemorrhage
In 2003, the International Federation of Gynecology and Obstetrics (FIGO) and the International Confederation of Midwives (ICM) issued a joint statement that has prioritized universal access to active management of the third stage of labor to respond to the urgent need to make real progress in reducing maternal mortality globally.
This toolkit is designed to provide useful, practical information and materials for health providers so that they can prevent postpartum hemorrhage through active management of the third stage of labor and advocate for necessary policy change to assure that active management of the third stage of labor is available to all pregnant women. The toolkit is not intended to be a comprehensive source for all materials related to prevention of postpartum hemorrhage, but rather focuses on selected tools that may be most useful to providers.
Many articles from the toolkit are available for download below as Portable Document Format (PDF) files.
Dowload toolkit sections
- Introduction (146 KB PDF)
- Section A: Call to Action (151 KB PDF)
- Section B: Evidence Base for Active Management of the Third Stage of Labor (2,777 KB PDF)
- Section C: Clinical Care and Treatment Guidelines for Prevention of Postpartum Hemorrhage (260 KB PDF)
- Section D: Drugs for Active Management of the Third Stage of Labor (2,525 KB PDF)
- Media Tools (374 KB PDF)
This animated demonstration accompanies the toolkit.
Note: The online version can be easily viewed on most computer systems, but may take longer to load via slower/dial-up Internet connections. If necessary, you may be prompted to install a free Macromedia Flash™ Player plug-in on your computer. The installation process is easy and should take only a few moments to complete. CD-ROM versions are available in English, French, and Spanish. Please contact us if you would like a copy.
WHO Recommendations for the Prevention of Postpartum Haemorrhage: (1495 KB PDF) This document describes the technical consultation process, evaluates the evidence using the GRADE methodology, and provides the full set of recommendations from the World Health Organization (WHO) Technical Consultation on the Prevention of Postpartum Haemorrhage held in Geneva October 18 to 20, 2006. It makes recommendations to continue WHO's support for AMTSL, identifies who can provide AMTSL, and gives support to the use of misoprostol for prevention of postpartum hemorrhage, based on the evidence.
Saving women’s lives: evidence-based recommendations for the prevention of postpartum haemorrhage: (93 KB PDF) This document reports on the WHO Technical Consultation on Prevention of PPH held from October 18 to 20, 2006 and gives recommendations from WHO on how to prevent postpartum hemorrhage. In addition to the recommendation that all skilled birth attendants (SBAs) should provide active management of the third stage of labor (AMTSL), it was also recommended that a uterotonic (either oxytocin or misoprostol) can be used alone to prevent postpartum hemorrhage, when there is not a trained SBA to provide AMTSL.The full Technical Consultation recommendations include that the uterotonic can be provided by a trained health worker (it does not state skilled birth attendant).
Global Survey on the Management of the Third Stage of Labor Reports These studies aim to provide ministries of health and their partners with data about the actual practice of AMTSL, including policy, provider-support, and supplies and logistics, along with the descriptive information necessary to assess AMTSL practices and identify barriers to its use in their country.
MPS Technical Update: Prevention of Postpartum Haemorrhage by Active Management of Third Stage of Labour (October 2006): (245 KB PDF) This WHO document outlines WHO's recommendation that active management of the third stage of labor be offered by all skilled attendants at every birth, giving the background, evidence, and steps for the intervention.
Misoprostol for Prevention of Postpartum Hemorrhage: An Evidence-based Review by the United States Pharmacopeia (USP): (605 KB PDF) This report provides the evidence tables behind the USP recommendation that prevention of postpartum hemorrhage be included as an indication in the USP Drug Information monograph on misoprostol.
Misoprostol for Prevention of Postpartum Hemorrhage: An Evidence-Based Review by U.S. Pharmacopeia (USP): (687 KB PDF) This poster summarizes the USP review of the evidence and conclusions on the use of misoprostol for the prevention of postpartum hemorrhage.
Directions in Global Health December 2006 issue: (450 KB PDF) This PATH publication highlights POPPHI's work on preventing postpartum hemorrhage.
Essential Medicines for Reproductive Health: Guiding Principles for Inclusion on National Medicines Lists: (487 KB PDF) This publication from WHO, the United Nations Population Fund, and PATH provides information on the process for including reproductive health medicines on national essential medicines lists at the country level based on the essential medicines concept. Injectable oxytocin is described on pages 102 to 104 of the document.
DRAFT DOCUMENT: Use of uterotonic drugs for prevention and treatment of postpartum hemorrhage in tropical climates: Guidance for essential drug and safe motherhood programs: (217 KB PDF) This draft document is being shared with the Prevention of Postpartum Hemorrhage Listserv for comment. If you would like to subscribe to the listserv, please visit the following website and follow the instructions. http://lists.path.org/mailman/listinfo/preventing_postpartum_hemorrhage.
Stability of injectable oxytocics in tropical climates Results of field surveys and simulation studies on ergometrine, methylergometrine and oxytocin: (1,281 KB PDF) This WHO publication presents information on the stability of uterotonic drugs for active management of the third stage of labor in tropical climates.
Active Management of the Third Stage of Labor: A Simple Practice to Prevent Postpartum Hemorrhage: This Global Health Technical Brief presents information on postpartum hemorrhage and active management of the third stage of labor.
Preventing Postpartum Hemorrhage: Managing the Third Stage of Labor: This issue of Outlook, PATH's quarterly reproductive health newsletter, reviews preventing postpartum hemorrhage through active management of the third stage of labor.
- Download/view (75 KB PDF)
- Versión español (123 KB PDF)
- Version française (66 KB PDF)
- Indonesian version (562 KB PDF)
Misoprostol Use in Obsetrics and Gynecology: This issue of Outlook, PATH's quarterly reproductive health newsletter, provides evidence-based information on the emerging use of misoprostol in obstetrics and gynecology.
First Aid for Women and Newborns Where Home Birth is Necessary or Common: This Global Health Technical Brief presents information on the Home Based Life Saving Skills program.
Managing Complications in Pregnancy and Childbirth A guide for midwives and doctors: This World Health Organization manual offers important information on complications including postpartum hemorrhage. Version française Versión español
Misoprostol and Postpartum Hemorrhage (PPH) Research, August 2006, Version 6 (PDF 56KB) This document, compiled by POPPHI, provides information of studies on the use of misoprostol in the prevention and treatment of postpartum hemorrhage, as of August 2006.