the safer motherhood
K n o w l e d g e Tr a n s f e r P r o g r a m
Editor-in-Chief: Professor Sir Sabaratnam Arulkumaran
The Active
Management of
the Third Stage
of Labor
G
THE GLOBAL LIBRARY OF WOMEN’S MEDICINE
www.glowm.com
, For more detailed information, see text on the reverse side of this leaflet
STEP
1 Assessment
Place the baby in skin-to-skin contact on the abdomen of the mother, dry the
baby, assess the baby’s breathing and perform resuscitation if needed. Cover the
baby’s head with a cloth or, preferably a hat/bonnet. Cover the woman and baby.
Note: This Wall Chart is color coded in the following way:
Black Steps that all providers would perform regardless of whether the
attendant is “skilled” and whether a uterotonic is administered
Blue Steps for active management of the third stage of labor (AMTSL)
when birth is attended by a skilled provider and injectable uterotonic
drugs are available
Green Steps for AMTSL when (1) oxytocin is not available and (2) the birth
attendant’s skills are limited
Purple Steps for AMTSL when (1) injectable uterotonic drugs are not
available and (2) the birth attendant is skilled and trained in AMTSL
, For more detailed information, see text on the reverse side of this leaflet
STEP
2 Uterotonic
Administer a uterotonic (oxytocin or misoprostol) within 1 minute after the
baby’s birth and after ruling out the presence of another baby (the uterotonic of
choice is oxytocin 10 IU IM).
Give 600 µg of misoprostol by mouth within 1 minute after the baby’s birth
and after ruling out the presence of another baby.
Give 600 µg of misoprostol by mouth within 1 minute after the baby’s birth
and after ruling out the presence of another baby.
K n o w l e d g e Tr a n s f e r P r o g r a m
Editor-in-Chief: Professor Sir Sabaratnam Arulkumaran
The Active
Management of
the Third Stage
of Labor
G
THE GLOBAL LIBRARY OF WOMEN’S MEDICINE
www.glowm.com
, For more detailed information, see text on the reverse side of this leaflet
STEP
1 Assessment
Place the baby in skin-to-skin contact on the abdomen of the mother, dry the
baby, assess the baby’s breathing and perform resuscitation if needed. Cover the
baby’s head with a cloth or, preferably a hat/bonnet. Cover the woman and baby.
Note: This Wall Chart is color coded in the following way:
Black Steps that all providers would perform regardless of whether the
attendant is “skilled” and whether a uterotonic is administered
Blue Steps for active management of the third stage of labor (AMTSL)
when birth is attended by a skilled provider and injectable uterotonic
drugs are available
Green Steps for AMTSL when (1) oxytocin is not available and (2) the birth
attendant’s skills are limited
Purple Steps for AMTSL when (1) injectable uterotonic drugs are not
available and (2) the birth attendant is skilled and trained in AMTSL
, For more detailed information, see text on the reverse side of this leaflet
STEP
2 Uterotonic
Administer a uterotonic (oxytocin or misoprostol) within 1 minute after the
baby’s birth and after ruling out the presence of another baby (the uterotonic of
choice is oxytocin 10 IU IM).
Give 600 µg of misoprostol by mouth within 1 minute after the baby’s birth
and after ruling out the presence of another baby.
Give 600 µg of misoprostol by mouth within 1 minute after the baby’s birth
and after ruling out the presence of another baby.
