The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) recommends the standardized use of oxytocin for active management of the third stage of labor to prevent postpartum hemorrhage, maximize maternal safety, and reduce instances of preventable morbidity and mortality.
According to The Joint Commission (The Joint Commission, 2019), each year approximately 700 women in the United States die from pregnancy related complications. The most frequent cause of severe maternal morbidity and preventable maternal mortality is obstetric hemorrhage (also called postpartum hemorrhage [PPH]) or excessive blood loss from giving birth (The Joint Commission, 2019). Uterine atony, failure of the uterus to contract after birth, accounts for 70% to 80% of cases of PPH (American College of Obstetricians and Gynecologists, 2017). Since 2007, the World Health Organization (World Health Organization, 2014) has supported active management of the third stage of labor (AMTSL) as a critical intervention to prevent PPH. Uterotonics, agents used to contract the uterus, should be initiated as a first-line intervention to prevent PPH caused by uterine atony (American College of Obstetricians and Gynecologists, 2017; World Health Organization, 2012). Oxytocin is the uterotonic of choice to reduce the incidence of PPH, and its use is universally recommended for all women (World Health Organization, 2012).
AWHONN Practice Brief Number 12: Guidelines for Active Management of the Third Stage of Labor using Oxytocin