Authors (including presenting author) :
Tao MTM (1), Ho HL (1), Lee YW (1), Mak WLS (1), Ng PSS (1), Wong KY (1), Yu HL(1), Yip MY (1), Li OC (1), Wong D (1)
Affiliation :
(1) Department of Obstetrics & Gynaecology, Pamela Youde Nethersole Eastern Hospital
Keyword 3: :
Uterine Fundal massage
Keyword 6: :
Postpartum complication
Introduction :
Postpartum haemorrhage (PPH) remains a leading cause of maternal morbidity. Routine teaching of self-uterine massage to mothers after delivery persists widely as a common but variably practiced among obstetric staff, often based on tradition rather than evidence for PPH prevention. This leads to inconsistent practices and maternal discomfort without proven benefit. This evidence-based project was conducted by O&G Innovative & Best Practice Team in the Department of O&G, PYNEH. It aimed to understand healthcare professionals' perceptions and then implement an evidence-based educational intervention to align clinical practice with current best available evidences.
Objectives :
• To assess staff perceptions and practices regarding teaching self-uterine massage. • To develop an evidence-based educational video. • To evaluate the video’s impact on staff future practice intentions.
Methodology :
This project was conducted from Jul 2024 to Nov 2025 and in four phases. Phase 1 (Pre-video survey): A questionnaire was distributed to obstetric staff to explore their current practices, beliefs and the rationale behind. Phase 2 (Intervention): A comprehensive literature review was conducted on the effectiveness of self-uterine massage in preventing PPH and confirmed a lack of robust evidences supporting its effectiveness alongside prophylactic oxytocin. The findings were synthesized into an evidence-based educational video. Phase 3 (Post-video survey): Staff viewed the video and completed a post-video survey evaluating changes in their understanding, perception of the evidences, and stated future practice intentions. Phase 4 (Follow-up education): Findings and reinforcement of practice change were disseminated in department meetings and lectures.
Result & Outcome :
Results Pre-video survey data (n=101) revealed a strong culture of routine teaching self-uterine massage (94.1% of participants), primarily motivated by tradition and perceived efficacy in preventing PPH. Post-video survey (n=83), a dramatic and statistically significant shift occurred: only 33.7% of staff intended to continue teaching it. Analysis of matched responses (n=75) demonstrated that 64% of participants changed their intention from “teaching” to “will not teach”. Paired responses were analyzed using McNemar's test (χ²(1) = 46.021, p < 0.001). Follow-up education was conducted to further convince the remaining staff to adopt the practice change which was enforced starting from Nov 2025. Conclusion This initiative successfully shifted clinical intentions through evidence-based education. The findings advocate clinical staff to stop the routine teaching of ineffective in PPH prevention, but often painful self-uterine massage. This aligns clinical practice with current best evidences, ultimately enhancing patient comfort and care quality.
