The current recommendations in maternity care is to offer all women an 'active management' of the third stage of labour/placental delivery. This is where a provider will inject you with a drug such as syntocinon or syntometrine and facilitate the delivery of the placenta by checking your abdomen for signs the placenta has separated from your uterus, waiting for the drug to take affect and either observing you birth the placenta or gently pulling on the umbilical cord to ease the placenta out with your permission. They need your informed consent to do this and should explain what they are doing throughout the procedure. 

 

Unfortunately, there is a very bad culture in some maternity services with providers who ignore clinical guidelines and attempt to pull out women's placentas before drugs have taken affect and without their informed consent. Some providers pull on the cord before checking for signs of separation or offering women the option of a physiological placental delivery. These practices are extremely dangerous and can result in severe and catastrophic hemorrhaging for women. In rare cases it has resulted in women's deaths. In other cases, roughly pulling on the umbilical cord cause it to snap, leaving a retained placenta and requires women going to theatre for removal under anesthesia.

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In light of all this, we have created an Information Sheet for women to take to their births and for their support people to utilise to help ensure safe care during the third stage of labour. Birth support or the woman who consent to active stage can ask questions and encourage the provider to communicate to the woman throughout the process of placenta delivery. This information sheet can also help women and their birth support spot deviation from guidelines and question if standard clinical practice is not being followed. 

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This information sheet or the logo can be added to your plan. Care will differ in the event of an emergency or a post-partum hemorrhage. This Information Sheet pertains to a normal managed placental delivery.

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