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Retrospective cohort study comparing current third stage management to expedient squatting third stage management
  • Judy Cohain,
  • Rina E. Buxbaum
Judy Cohain
Hebrew University
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Rina E. Buxbaum
Hadassah Medical Center
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Abstract Objective: To compare current the third stage management to expedient squatting at 3 minutes postpartum. Design, Setting, Sample and Methods: A retrospective cohort study of 1,098 planned, attended low risk vaginal births in Israel using Judy’s 3,4,5 minute third stage protocol compared to 2,691 attended low risk vaginal births in British Columbia using various forms of active or expectant management of the third stage of labor. Main Outcome measures: PPH>1000, PPH>500 and manual removal of placenta Results: Among similar groups of low risk births, active management, or expectant management resulted in 4.1% PPH over 1000 cc, whereas Judy’s 3,4,5 minute protocol resulted in 0% PPH over 500 cc. Conclusion: Evidence supports less postpartum bleeding and postpartum hemorrhage when women deliver the placenta in squatting 3 minutes after birth. The risks are minimal and the data suggests the likelihood of a very positive outcome, making it recommended for practitioners in all settings to try it.