Background: Postpartum haemorrhage is still the primary cause of maternal death, particularly in underdeveloped nations. We aimed to see how tranexamic acid and oxytocin compare in terms of preventing postpartum haemorrhage and lowering blood loss, hospital stay, morbidity, and death during vaginal birth.Patients and methods: A prospective, randomised clinical trial study was conducted on 92 pregnant women who were being prepared for vaginal delivery and were divided into two groups: Group (A) (TXA group) (46 patients) received 1 gm of tranexamic acid and Group (B) (Non-TXA group) (46 patients) received 10 IU of oxytocin. Hemoglobin and hematocrit readings were tested before and 24 hours after vaginal delivery, and additional basic laboratory tests were performed.Results: In our study, there was no significant difference in HB at the pre-test, but the Non-TXA group was considerably lower at the post-test, and the Non-TXA group had a significant reduction. At the pre-test, there was no significant difference in HCT, but the Non-TXA group was considerably lower at the post-test, and the Non-TXA group had a significant reduction. In the TXA group, the difference in HCT was much smaller. The TXA group had considerably less blood loss.Conclusion: The use of tranexamic acid during delivery may assist to minimise blood loss. It is a low-cost and widely available medication. The use of TXA reduces the requirement for uterotonics, lowering morbidity and mortality.