PPH with Ilaleit Lindah Ruth

As a passionate, committed, loving and caring midwife of Busiu H/C IV, Mbale district.

   I vow to ensure that no mother dies in my hands of excessive bleeding that's why I start preventing from Antenatal until six weeks postpartum.

 **DURING ANTENATAL.* 

 *1.IDENTIFICATION AND MANAGEMENT OF RISK FACTORS.** 

I make sure that all pregnant mothers are assessed for risk factors i.e past obstetrical history of P.P.H, multiple pregnancy, uterine fibroids, placenta praevia the importance of how to recognize signs of P.P.H and seek immediate healthcare and it's conducted in sessions since some mother's come late and end up missing the information.

2. *PREVENTION OF* *MALARIA **  *AND** *ANAEMIA.** 

 I ensure that no mother is anaemic by encouraging mother's to eat iron rich foods and swallow ferrous sulfate tabs daily and pyrimethamine sulfadoxine DOT in ANC. 

3. *FAMILY PLANNING VS* *HIGH PARITY .* 

 As amaster coach of family planning I encourage mother's to choose long-term methods as Immediate postpartum family planning within 48hours of giving birth.

 **__*_DURING LABOUR* *AND DELIVERY._*__** 

 *1.READINESS OR PREPAREDNESS PLAN FOR EMERGENCIES.* 

  As a committed midwife must have a plan in place for managing P.P.H Incase emergency arises.   Make sure all mother's in active stage of labour  are monitored using partograph including access to complete emergency kits of P.P.H and potential interventions. 

 *2.BLADDER.* 

    Ensure the bladder is empty by inserting a catheter.

 *3. ACTIVE MANAGEMENT OF THIRD STAGE OF LABOUR.* 

          Administration of auterotonic drug like Oxytocin immediately the baby is born is key and use of controlled cord traction technique to deliver the placenta.

 *4.ADDRESS RETAINED PLACENTA.* 

   I consider manual removal of the placenta Incase it's not delivered within reasonable time.

 *5.MANAGEMENT OF PERINEAL TEARS.* 

  All mother's with perineal tears or episiotomies are repaired promptly and carefully.

 *6.MONITOR BLOOD LOSS* .

  During and after delivery carefully estimate blood loss and be aware of significant blood loss like hypotension and rapid heart rate.

 *7.CONTINEOUS MONITORING OF VITALS.* Closely observe and monitor mother's vitals every 30m i.e Blood pressure, pulse, respiration , temperature and signs of excessive bleeding.

By implementing these strategies midwives can significally reduce the risk of excessive bleeding starting from Pregnancy, during and after childbirth contributing to safer outcomes and the new babies. 

  

  TO LOVE AND SERVE 🙏 🙏 

  UNTILL I REACH MY GOAL.

 *BY: IALEIT LINDAH    RUTH 

        MIDWIFE 

        BUSIU H/C IV.

        MBALE DISTRICT*