Abstract
BACKGROUND: Postpartum hemorrhage (PPH) stands out as a primary preventable cause of maternal mortality and morbidity. Therefore, the management and monitoring of PPH are of critical importance during the perinatal period. To evaluate the effectiveness of breastfeeding, uterine massage, and perineal protective approaches for preventing PPH during the perinatal period. METHODS: This comparative controlled clinical study included 70 women in a tertiary care maternity hospital in Ankara, Turkey. Women were randomized according to age, parity, and optimality index-TR (OI-TR). Data were collected using sociodemographic and obstetric data collection forms, the LATCH Breastfeeding Assessment Tool, visual analog scale, and OI-TR. In addition to PPH awareness training, perineal protective techniques (perineal massage and open-glottis pushing technique), uterine massage, and breastfeeding support were provided to the intervention group (IG). Pregnant women in the control group (CG) underwent routine hospital procedures and care. Postpartum blood loss was measured in all groups. RESULTS: The mean blood loss in women in the IG was significantly lower than that in the CG (r = 0.424, P < .05). However, no statistically significant difference was observed between the incidence of PPH (IG = 9.1%; CG = 27%) exceeding 500 mL in either groups (P > .05). Perineal laceration, delayed initiation of breastfeeding, a short breastfeeding duration, and a low OI-TR score were associated with high blood loss in the IG (r = 0.528, r = 0.392, r = 0.387, r = 0.457, P < .05). In the regression analysis performed by taking the variables found to be significant in univariate analyses, it was determined that the group effect was significant when the effects of other variables on PPH were ignored (β = 110.384, P < .01). However, when other variables were kept constant, the group effect was insignificant (β = 37.643, P = .607). CONCLUSIONS: Optimal care provided by midwives and nurses to support breastfeeding and implement perineal protective techniques reduces the risk of postpartum hemorrhage.