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The last series of pains had gained in intensity and she suspected Michelle would soon be entering the third stage of labor.
Active management of labor with oxytocin is recommended in the third stage of labor.
"The ability to maintain long-term pushing in the third stage of labor, when the woman has to dispel the baby, is directly related to stamina," she said.
Credé is also credited for implementing a procedure to hasten delivery of the placenta during the third stage of labor.
The period from just after the baby is expelled until just after the placenta is expelled is called the third stage of labor.
Retained placenta is a condition where all or part of the placenta or membranes are left behind in the uterus during the third stage of labour.
A Cochrane database study suggests that blood loss and the risk of postpartum bleeding will be reduced in women offered active management of the third stage of labour.
Even when an oxytocic agent is not given a small proportion of patients show an increase in plasma oxytocin concentration during the late second or early third stage of labour.
The third stage of labor can be managed actively, or it could be managed expectantly (also known as physiological management or passive management), the latter allowing the placenta to be expelled without medical assistance.
A Cochrane review suggests that active management (use of uterotonic drugs, cord clamping and controlled cord traction) of the third stage of labour significantly reduces severe maternal bleeding and anemia compared to expectant management.
In a joint statement, World Health Organization, the International Federation of Gynaecologists and Obstetricians and the International Confederations of Midwives recommend active management of the third stage of labour in all vaginal deliveries to help to prevent postpartum hemorrhage.
An injection of syntometrine is given in the third stage of labor, just after the birth of the child, to facilitate delivery of the placenta and to prevent postpartum hemorrhage by causing smooth muscle tissue in the blood vessel walls to narrow, thereby reducing blood flow.