Primary postpartum hemorrhage is a leading cause of maternal mortality and morbidity internationally. Research comparing physiological (expectant) and active management of the third stage of labor favors active management, although studies to date have focused on childbirth within hospital settings, and the skill levels of birth attendants in facilitating physiological third stage of labor have been questioned.
Davis, D., Baddock, S., Pairman, S., Hunter, M., Benn, C., Anderson, J., ... Herbison, P. (2012). Risk of Severe Postpartum Hemorrhage in Low-Risk Childbearing Women in New Zealand: Exploring the Effect of Place of Birth and Comparing Third Stage Management of Labor. Birth, 39(2), 98-105. https://doi.org/10.1111/J.1523-536X.2012.00531.X