Abstract

The third stage of labour marks the final stage of the transition from woman to mother. For most women or parents this is a particularly precious moment as they meet their baby for the first time. Yet the medical paradigm views this final juncture as the most dangerous stage of labour. While there may be an essence of truth in this approach, in the Western world it could be considered as a historical legacy from childbirth dating back to the 19th century when postpartum haemorrhage was a devastating cause of maternal mortality and morbidity. Medicalization of childbirth was seen to be an attractive innovation without risk at this time. It Is questioned whether this legacy has relevance In contemporary maternity care where women's improved nutrition and social conditions have reduced morbidity and mortality from postpartum haemorrhage. This article discusses the current evidence on physiological verses active management of the third stage of labour. However it focuses primarily on how to support women during a physiological third stage of labour and proposes a study designed to further explore the essence of this support.