2025, Vol. 8, Issue 1, Part A

Materials and Methods: A cross-sectional descriptive study was conducted among 120 practicing midwives across five healthcare facilities in Gaya. Data were collected using a structured knowledge questionnaire and an observational checklist assessing real-time practice. Descriptive and inferential statistics were used for analysis.

Results: While 78.3% of participants demonstrated adequate knowledge of AMTSL, only 55.8% adhered to all three components—timely uterotonic administration, controlled cord traction, and uterine massage—in practice. Midwives with recent training and over five years of experience showed significantly better adherence (p < 0.05). Uterine massage was the most frequently missed component.

Discussion: The study revealed a clear gap between knowledge and actual practice. Factors such as limited refresher training, drug availability, and high workload influenced implementation. Strengthening training programs and facility-level support mechanisms are essential to bridge this gap.

Conclusion: Despite satisfactory knowledge levels, the inconsistent application of AMTSL highlights a need for regular skill-based training, supportive supervision, and better logistical support to improve maternal outcomes and reduce PPH-related mortality.