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Re: Active management - third stageFrom: Jane Wines (jane.wines@telus.net)Tue Oct 11 19:11:13 2005
So how do you manage 3rd stage. Do you just wait and see - give it upto 1 hour.... I was interested as in the UK I was taught active 3rd stage was admin of oxytocic and CCT OR complete hands off and have a physiological 3rd stage - no hands on cord - wait for it to come naturally. The recommendation in the UK and here in Canada is the first (although in the UK it was not with the ant shoulder - just straight after birth). Midwives tend to do the latter more in Canada, and in the UK it depends on practitioner. We were told that under no circumstances were you to perform CCT if there had been no oxytocin. Here I have seen women ask for a natural 3rd stage, and the only difference has been no oxytocin - but the placenta is still out in just a few minutes with CCT - to my mind this *must* increase the rate of PPH. Good to know what you do in the US. Is it because there is a high use of oxytocin in labour - so maybe removing the rationale for IM oxytocin -ie just open up the IV? Jane RM Canada
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