Training on "Active Management of Third Stage of Labor (AMTSL)"

Once a baby is born, the womb (uterus) continues to contract, causing the placenta to separate from the wall of the uterus. The mother then delivers the placenta, or 'after-birth'. This is called expectant management of third stage of labour. 

Active management of third stage involves three components: 1) giving a drug (a uterotonic) to help contract the uterus; 2) clamping the cord early (usually before, alongside, or immediately after giving the uterotonic); 3) traction is applied to the cord with counter-pressure on the uterus to deliver the placenta (controlled cord traction). 

Mixed management uses some, but not all, of the three components. 

Active management was introduced to try to reduce severe blood loss at birth. This is a major cause of women dying in low-income countries where women are more likely to be poorly nourished, anaemic and have infectious diseases. In high-income countries, severe bleedin