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I haven't got any specific literature to quote but I do have a good book called "Delivering your placenta - the 3rd stage" but out by AIMS. It discusses physiological and active management and does mention waiting for signs of separation. It also discusses pro's and con's of both. A recommend reading it. I think I brought it from Birth International and it didn't cost a lot.
I too have seen many different approaches to active management - a few quite disturbing!
-------Original Message-------
Date: 20/02/2005 10:20:22 a.m.
Subject: RE: [ozmidwifery] question
You must wait for placental separation, otherwise you risk inverting the uterus Maureen
Dear ozmid list-ners
I have not been on the list for a while but have a question that I would welcome your input on.
When performing active management of the third stage, is it routine practice to await signs of placental separation before commencing CCT, or to simply ascertain that there is uterine contraction?
Also, what is the current recommendation for management of retained placenta, or situations when the cord separates during CCT?
I know this may sound odd, and I know what I was taught and have practiced, but I am in the midst of a "difference of opinion" and I need to check what are the actual guidelines given. I have attempted to search this out myself but have not been able to find much in the way of actual step-by-step instructions for active management of the third stage.
With respect, I do not need to know people's preferred methods or opinions on the rights and wrongs of active management, simply the actual guidelines for active management and when to commence CCT. I would be grateful if anyone can post this or lead me to it. I have tried many sites on the net without success and do not have easy access to up to date manuals.
Thank you in advance, I have been "off list" for quite a while due to being very busy! Looking forward to listening in again now that life is a bit quieter.
Susan Cudlipp
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