THE MANAGEMENT PROCEDURE FOR THE FOURTH STAGE OF LABOR IN SOUTHWESTERN IRAN

Introduction: In each of the four stages of labor, including dilatation, embryo withdrawal, placental withdrawal, and an hour after labor, there is a potential for multiple complications that can lead frequent increase in maternal mortality and morbidity. Despite the vital importance of maternal control at the first hour after labor, referred to as the fourth stage of delivery due to its importance, unfortunately, there are still few studies with emphasis on the fourth stage of labor in the world and Iran. Therefore, the present study aims to determine the management procedure for the fourth stage of labor in Khuzestan Province. Method: This study was a descriptive study conducted on 14 randomly selected hospitals in Khuzestan. The information form used was a researcher-made form, the validity and reliability of which were confirmed by content validity and simultaneous observation. The researcher completed the first part questions after entering the delivery department, and then then personally observed the process of controlling parturient woman from the beginning of the fourth stage and completed other parts of the information form in accordance with the measures taken by the childbirth agents. Results: Uterine massage was immediately performed after labor and follow-up on the basis of the routine of the hospital and not according to the country's protocol of natural delivery. Inadequate care needed in the early hours after delivery, during which the highest maternal mortality and maternal complications occur, was seen in a number of cases. Family planning education, baby care, postpartum nutrition and personal health care were performed in 64.9%, 67.7%, 59% and 77.8% of deliveries, respectively. Conclusion: It is recommended that authorities put emphasis on the implementation of childbirth practices consistent with the national protocol for normal delivery and the assessment of maternity hospitals based on this protocol. Keywords: Fourth stage of labor, postpartum hemorrhage, maternal postpartum education