Active Management of Third Stage of Labor (AMTSL): A Lifesaving Practice

The third stage of labor, from baby’s birth to placental delivery, is crucial. It’s also when the risk of Postpartum Hemorrhage (PPH)—a leading cause of maternal mortality—is highest. This is where Active Management of Third Stage of Labor (AMTSL) comes in as a vital, evidence-based intervention.

What is AMTSL? It’s a package of interventions designed to prevent excessive bleeding by ensuring the uterus contracts effectively and the placenta separates smoothly. The core components, as per WHO guidelines, include:

* Administration of a Uterotonic: Preferably Oxytocin, given immediately after the baby’s birth, to help the uterus contract.

* Controlled Cord Traction (CCT): Gentle pulling on the umbilical cord while counter-traction is applied to the uterus, to aid placental delivery.

* Uterine Massage: Rubbing the fundus of the uterus after placental delivery to ensure it remains firm and well-contracted.

AMTSL significantly reduces the incidence of PPH by promoting uterine contraction, minimizing blood loss, and facilitating placental expulsion. It’s a critical skill for every birth attendant, contributing immensely to safer childbirth outcomes glo

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