Active versus Physiological Third Stage of Labour
This essay will examine the evidence based research on the topic of the methods currently
used in the management of the third stage of labour, which are described as active and
physiological. The essay will commence with an explanation of why this topic has been
chosen followed by a brief explanation of the physiology of the third stage of labour. The
advantages and disadvantages of both methods will then be discussed and finally, the role of
the midwife, the issue of informed consent and the needs of the mother will be discussed.
I have chosen this topic for a number of reasons. Firstly, the use of physiological
management of the third stage of labour was rarely used when I trained as a midwife and,
therefore, I have not had the chance to examine the theory surrounding this practice. It is
important that I do this not only to keep myself updated and meet Nursing and Midwifery
Council prep recommendations but also to enable me to support student midwives’ learning
and fulfil my role in offering informed choice to the women in my care. ( Stapleton et al
2002). Giving women clear, accurate, evidence based information when I am discussing each
method of management of the third stage of labour allows a plan of care to be devised
which is appropriate for each individual.
The third stage of labour extends from the birth of the baby to the expulsion of the
placenta and membranes.( Llewellyn-Jones 1994) During this stage, the uterus contracts and
the placenta separates from the uterine wall. The uterus remains contracted and blood
vessels in the now exposed placental bed are compressed by the contraction and retraction of
the myometrium and haemostasis is achieved. Once separated, the placenta is expelled from
the uterus into the vagina through the open cervix.
During this stage of labour the primary objective is prevention of...