uterine massage to reduce postpartum hemorrhage in women expected to deliver normally: A randomised trial

INTERVENTION: Before delivery of the placenta, uterine massage will be done till the uterus gets contracted and do controlled cord traction. After delivery of the placenta, massage is done every 10 minutes for 30 minutes. CONDITION: postpartum hemorrhage reduction of postpartum hemorrhage in women expected to deliver normally. third stage of labour PRIMARY OUTCOME: Blood loss >300ml within 30 minutes. It is measured using calibrated plastic drape placed under the buttocks of the woman. Placenta delivered >30 minutes after birth. SECONDARY OUTCOME: Blood loss 500 ml in 30 minutes (blood loss will be measured for 30 minutes). It is measured using calibrated plastic drape placed under the buttocks of the woman Blood transfusion. Number of women requiring blood transfusion. Haemoglobin level after 12‐24 hours < 8g/100ml. it is assessed by laboratory methods. Maternal morbidity. Number of women admitted to intensive care unit(ICU) or with prolonged hospital stay or developed complications. Median time to placental delivery/ placenta undelivered after 30 minutes. Use of additional uterotonics or other procedures for management of postpartum hemorrhage. Number of women who needed additional uterotonics after procedrue. INCLUSION CRITERIA: Pregnant women expected to deliver normally will be given information about the study and be invited to participate.