Inclusion Criteria:  All women age ≥ 18 years (age of legal consent) Singleton pregnancy >= 34 weeks  Exclusion Criteria:  Women planning for Caesarean section Women with known risk factors for PPH, including grand multiparity (>=4), multiple pregnancy, fibroid with size >4cm, history of PPH, placenta previa, large-for-gestational age fetus (defined as EFW >90th centile), polyhydramnios, and previous Caesarean section. Women with bleeding tendency or thrombocytopenia < 100 x 109/L Women on anticoagulant or aspirin Women in whom use of misoprostol / syntocinon / syntometrine is contraindicated Women with known hypersensitivity to misoprostol / syntocinon / syntometrine