Box A: Recommendations for the prevention of PPH
1. The use of uterotonics for the prevention of PPH during the third stage of labour is recommended
for all births. (Strong recommendation, moderate-quality evidence)
2. Oxytocin (10 IU, IV/IM) is the recommended uterotonic drug for the prevention of PPH.
(Strong recommendation, moderate-quality evidence)
3. In settings where oxytocin is unavailable, the use of other injectable uterotonics (if appropriate
ergometrine/methylergometrine or the fixed drug combination of oxytocin and ergometrine)
or oral misoprostol (600 μg) is recommended. (Strong recommendation, moderatequality
evidence)
4. In settings where skilled birth attendants are not present and oxytocin is unavailable, the
administration of misoprostol (600 μg PO) by community health care workers and lay health
workers is recommended for the prevention of PPH. (Strong recommendation, moderatequality
evidence)
5. In settings where skilled birth attendants are available, CCT is recommended for vaginal
births if the care provider and the parturient woman regard a small reduction in blood loss
and a small reduction in the duration of the third stage of labour as important (Weak recommendation,
high-quality evidence)
6. In settings where skilled birth attendants are unavailable, CCT is not recommended. (Strong
recommendation, moderate-quality evidence)
7. Late cord clamping (performed after 1 to 3 minutes after birth) is recommended for all births
while initiating simultaneous essential newborn care. (Strong recommendation, moderatequality
evidence)
8. Early cord clamping (