Monitoring of the third and final stage of labor, the birth of the placenta, needs to be more closely monitored. Postpartum hemorrhage is increasing, with very negative effects on maternal outcomes. The placenta itself is wonderful for helping to stop hemmorhage – placing a small piece of fresh placenta on the inside of the cheek allows for quick transfer of the hormone oxytocin, which prompts the uterus to contract, helping to stop postnatal bleeding.
Post-partum haemorrhage (PPH) immediately after giving birth is the largest threat to new mothers in high-income countries. An Australian study, featured in the open access journal BMC Pregnancy and Childbirth, shows that an increasing number of women suffered severe problems arising from blood loss after delivery.
The consequences of adverse maternal outcomes can include infertility, psychological effects, disability and even death. According to Roberts, “Active management of the third stage of labour, delivery of the placenta, is effective in reducing PPH. Unfortunately, adherence to active third-stage management recommendations is poorly reported and/or suboptimal in Australia, and significant variations in policies and practice have been reported in Europe. Suboptimal adherence to active management guidelines could explain the rising PPH rates”.
The authors found that between 1999 and 2004 the annual rate of adverse maternal outcomes increased by 20.9%. This increase occurred almost entirely among women who had a PPH.
The authors conclude, “We feel that all women should have access to active management of the third stage of labour and careful observation in the first two hours after delivery, as this may reduce the PPH rate and the potential for severe harm and death”.
