Managing the third stage

The third stage of labor runs from the birth of the baby to the delivery of the placenta. Research on its management centers on a comparison between active and expectant approaches. A systematic review examines active versus expectant management for women in the third stage of labour, and a World Health Organization-linked publication in the Optimal Intrapartum Care series addresses management of the third stage of labour.

Other papers look at how these approaches are understood and used. A systematic review and meta-analysis examines knowledge and factors associated with active management in sub-Saharan Africa, and a scoping review looks at midwives' physiological approach at the third stage. Reference entries on normal labor and vaginal delivery describe the physiology and routine care around this stage.

Parents often ask what happens after the baby is born, how long the placenta takes, what the injection or cord handling involves and whether the uterus is massaged. Researchers continue to look at how different approaches compare and how they are used in practice, and results vary by setting.

An educator may want slides that explain what each approach includes and why the terms active and expectant are used. The papers listed below are the ones the Hub tracks on this topic.