As a birth nerd, I’m supremely interested in subjects like how the placenta detaches and leaves the uterus, and what happens after. And as a former sufferer of postpartum hemorrhaging, I love knowledge that can keep it from happening again.
I thought her conclusions were very interesting: In a hospital, you’re unlikely to have a completely hands-off third stage of labor (i.e., the time you birth the placenta); therefore, so-called active management might be best for avoiding PPH, based on studies. However, in a relaxed environment where the birth can be purely physiological, then a physiological birth of the placenta can also be safe and effective. My second birth was like that: low lights, low noise, low stress, skin-to-skin just after birth — and no PPH this time around. I know of women who’ve had serene home births that ended in PPH, however, so I’d love to see more studies on the topic to tease out which method is preferable in terms of maternal safety.