I have a blog post scheduled later today with the news of this study, but I wanted to share it here, too. Previous research has compared active management with doing nothing during third stage, only in hospital settings, and probably with many "standard" hospital protocols in place, and has found active management to be associated with lower postpartum hemorrhage rates than the hospital version of expectant management, but PPH rates with how midwives do expectant management in out-of-hospital settings haven't been studied before. This study found that for low-risk women, when midwife-supported holistic physiological 3rd stage management is compared with active management, the PPH rate for the active management group was significantly higher (11.5%) than the physiological method (1.7%).
Holistic physiological care compared with active management of the third stage of labor for women at low risk for postpartum hemorrhage
The tough thing about natural third stage is that it is conditional on not having your baby taken away--if they take the baby off your chest, you can't count on expectant management to work. And unfortunately, in my experience, bait-and-switch is really common with delayed cord clamping in hospitals--there is always some excuse for why they have to cut the cord and take the baby to the warmer.
Not surprising at all. Thanks for sharing - I'll be passing this along to clients/health care providers I encounter.
It's a hot topic in my area.
Married to Mark 05.25.07
DD Stella Gabrielle - 12.31.07
DS Sebastien David - 01.06.09
DD Selene 'Lilu' Katherine Alice 03.16.11
Homebirthing, breastfeeding, attachment parenting momma