Management practices of primary postpartum hemorrhage among traditional birth attendants: a qualitative survey, Iganga, Uganda

Abstract

Postpartum hemorrhage is a significant barrier to the achievement of Sustainable development goal 3.1, given that it is associated with more than a quarter of all maternal mortality cases. Traditional birth attendants (TBAs), who are outlawed in many countries, including Uganda inclusive, attend to about 33% of all births globally. The objective of this study was to explore the management practices of primary postpartum hemorrhage among traditional birth attendants in Iganga district. The study used a case phenomenological qualitative exploratory design, targeting traditional birth attendants. Snow balling was used to select participants and engage them in-depth interviews. Data collected was analyzed thematically, with the induction approach. It was found that TBAs carried out PPH assessment using three methods; quantification of blood lost using household cups, vital assessment and visual assessment. Visual assessment was the most dominant. Postpartum hemorrhage resuscitation practices mainly rotated around the use of warm water. They did not carry resuscitation. The treatment interventions used were: use of herbal medicine and referral of severe cases to hospital. TBAs in Iganga district visually assess postpartum hemorrhage but they do not conduct resuscitation procedures. They use herbal uterotonics in the treatment of postpartum hemorrhage alongside with referral to hospital.