In plain words
Active management of the third stage is a set of steps used after birth. The is the time from the baby's birth until the placenta is delivered. Active management usually includes a medicine that tightens the uterus, gentle pulling on the cord once it stops pulsing, and a check of the placenta. Many hospitals use it routinely, and it lowers the chance of heavy bleeding compared with waiting. Some mothers choose physiologic management, which waits for the placenta to come out on its own, often with . Either way, your team watches for bleeding. Heavy bleeding or dizziness after birth is something to tell the team about right away.
The deeper version
Active management of the third stage (AMTSL) combines prophylactic administration, usually given at the birth of the baby or just after, with controlled cord traction and uterine massage. The Cochrane review by Begley and colleagues (2019) found that active management reduces and transfusion compared with expectant management, with more nausea and vomiting. The California Maternal Quality Care Collaborative hemorrhage toolkit stages the response to , with Stage 1 at over 500 mL vaginal or 1,000 mL with normal vital signs. The controversy centers on whether routine uterotonic use should be the default in low-risk births.
Where it comes up
- Heavy bleeding after birth (hemorrhage)Birth and the First Days
- The stages of labor, plainlyBirth and the First Days
- Planning a cesareanGetting Ready for Birth
What mothers here say about active management of the third stage
No one has posted under this term yet.
Sources
- Begley CM and colleagues, Cochrane Database of Systematic Reviews — Active versus expectant management for women in the third stage of labour (2019)
- California Maternal Quality Care Collaborative — Obstetric Hemorrhage Toolkit