Exploring Midwives’ Experiences and Practices of Active Management of the Third Stage of Labour at Northern Regional Hospital, Ghana
Francis K. Larle
College of Nursing and Midwifery, P.O. Box 60, Sampa, Bono Region, Ghana.
Diana Akubori
Community Health Nurses Training College, P.O. Box 233, Tamale, Northern Region, Ghana.
Vivian Annan
Nursing and Midwifery Training College, PMB 4, Sunyani, Bono Region, Ghana.
Rashida Atrime
Nurses and Midwives Training College, P.O. Box 565, Tamale, Ghana.
Mary P. Dwomoh
College of Nursing and Midwifery, P.O. Box 2066, Tanoso, Ahafo Region, Ghana.
Mavis Amponsah
Nursing and Midwifery Training College, PMB 4, Sunyani, Bono Region, Ghana.
Regina Amponsah
College of Nursing and Midwifery, P.O. Box 2066, Tanoso, Ahafo Region, Ghana.
Ali Mavis
College of Nursing and Midwifery, P.O. Box 2066, Tanoso, Ahafo Region, Ghana.
Esther Munufie
College of Nursing and Midwifery, P.O. Box 2066, Tanoso, Ahafo Region, Ghana.
Mohammed A. Kojo
College of Health, P.O. Box 10, Nalerigu, North East Region, Ghana.
Sabina Eduku
Presbyterian Nursing and Midwifery Training College, P.O. Box 47, Dormaa-Ahenkro, Bono Region, Ghana.
Stephanie Gyamfi
St. Patrick's Nursing and Midwifery Training College, P.O. Box 17, Offinso-Maase, Ashanti Region, Ghana.
Juliet Abu
*
College of Nursing and Midwifery, P. M. B 4, Sunyani - Bono Region, Ghana.
Adu Boahemaa Otchere
School of Nursing and Midwifery, Department of Adult Health, University of Cape Coast, PMB University Post Office, Cape Coast, Central Region, Ghana.
*Author to whom correspondence should be addressed.
Abstract
Background: Postpartum haemorrhage (PPH) remains a leading cause of maternal mortality globally and in Ghana. Active Management of the Third Stage of Labour (AMTSL) is a proven intervention for preventing PPH, yet its consistent implementation in clinical practice remains a challenge, particularly in resource-limited settings. The study aimed to explore midwives’ experiences and practices of AMTSL at Northern Regional Hospital, Tamale.
Methods: An exploratory descriptive qualitative design was adopted. Fourteen registered midwives working in the labour ward, maternity ward, and antenatal clinic were purposively selected. Data were collected through in-depth interviews, transcribed verbatim, and thematically analyzed using Braun and Clarke’s framework. Reflexivity and Lincoln and Guba’s trustworthiness criteria ensured methodological rigour.
Results: Midwives demonstrated strong knowledge of AMTSL and consistently administered oxytocin within one minute after birth, reflecting adherence to the most critical step. However, uterine massage and controlled cord traction were applied inconsistently, mainly due to staff shortages, heavy workload, concerns about oxytocin potency during power outages, and limited refresher training. Despite these challenges, midwives expressed a strong commitment to maternal safety and proposed practical solutions, including regular refresher training, improved staffing, reliable logistics, and supportive supervision.
Conclusion: Midwives expressed strong commitment to maternal safety and proposed practical solutions including regular refresher training, improved staffing, reliable logistics, supportive supervision, and targeted educational programs addressing knowledge gaps.
Keywords: Active management of the third stage of labour, midwives, postpartum haemorrhage, maternal health