Retrospective cohort study comparing current third stage management to
expedient squatting third stage management
Abstract
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.