Uterine massage to reduce blood loss after vaginal delivery

Erkaya R., Karabulutlu O., Calik K.

HEALTH CARE FOR WOMEN INTERNATIONAL, vol.44, no.10-11, pp.1346-1362, 2023 (SSCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 44 Issue: 10-11
  • Publication Date: 2023
  • Doi Number: 10.1080/07399332.2021.1940184
  • Journal Indexes: Social Sciences Citation Index (SSCI), Scopus, Academic Search Premier, International Bibliography of Social Sciences, Abstracts in Social Gerontology, CAB Abstracts, CINAHL, Educational research abstracts (ERA), EMBASE, Gender Studies Database, MEDLINE, PAIS International, Psycinfo, Public Affairs Index, Social services abstracts, Sociological abstracts
  • Page Numbers: pp.1346-1362
  • Karadeniz Technical University Affiliated: Yes


Postpartum hemorrhage (PPH) is a major cause of maternal mortality and disability. A need for simple, inexpensive techniques to prevent PPH and provide treatment exists, particularly in cases where uterotonics cannot be accessed. Uterine massage is recommended as part of the routine active management of the third stage of labor. This study was conducted to determine the effectiveness of uterine massage after delivery of the placenta in reducing postpartum blood loss. Thus, a randomized controlled trial was conducted in Turkey between March 2018 and September 2018. A total of 176 pregnant women (88 in the control and 88 in the uterine massage groups) were randomly allocated to the two groups: one group receiving sustained uterine massage, while the other comprising the control group. The uterine massage group was administered transabdominal uterine massage, starting immediately after delivery of the placenta and continuing every 15 min for a duration of 2 h until the uterus hardened. The blood loss within 2 h of delivery was recorded. Level of significance was taken as p < 0.05, and the chi-square, t, and Mann-Whitney U tests as well as Spearman's correlation and linear regression were employed in the analysis of the data. The average amount blood loss within 2 h of the delivery was significantly higher in the control group than in the massage group (X = 170.49 +/- 61.46 and X = 186.20 +/- 47.59, p < 0.05). A statistically significant difference was present between the uterine massage and control groups in terms of hemoglobin, hematocrit, WBC, and RCB pre-delivery and pre-discharge (first 24 h) values and in the use of additional uterotonics and the amount of blood loss (p < 0.05). The results of the analysis show that postpartum uterine massage has a reducing effect on the amount of PPH.