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Management of the Third Stage Of Labor: An Evidence‐Based Approach
Author(s) -
Brucker Mary C.
Publication year - 2001
Publication title -
the journal of midwifery and womens health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.543
H-Index - 62
eISSN - 1542-2011
pISSN - 1526-9523
DOI - 10.1016/s1526-9523(01)00192-1
Subject(s) - third stage , expectant management , medicine , hydrotherapy , watchful waiting , evidence based management , stage (stratigraphy) , childbirth , obstetrics , pregnancy , intensive care medicine , alternative medicine , gestation , training (meteorology) , paleontology , physics , pathology , prostate cancer , cancer , biology , meteorology , genetics
The third stage of labor usually is eclipsed by the excitement of the birth of a baby. Evidence shows that management of this stage can directly influence important maternal outcomes such as blood loss, need for manual removal of the placenta, and postpartum hemorrhage. Most of the large trials have compared active management of the third stage to expectant management. Active management includes routine use of cord traction and uterotonins, whereas expectant management can be characterized as one of watchful waiting. The use of herbal therapies and homeopathic remedies lack study; additional factors such as site of birth and hydrotherapy also remain to be explored. However, on the basis of current evidence, if a decrease in postpartum bleeding or avoidance of manual removal is desired, an active approach to third stage is the one that should be adopted until and unless contradictory findings are published.