The study was undertaken to evaluate the acceptability and ease of use of the Uniject prefilled, single-use injection device by midwives at primary and secondary level facilities, the effectiveness of active management of the third stage of labor (AMTSL) in reducing rates of post partum hemorrhage (PPH) and the need for hemorrhage treatments, the cost-effectiveness of routine delivery of AMTSL, and the relative costs of using oxytocin in ampoules or in Uniject. The study was conducted in six districts of Thanh Hoa province from June to December 2004.