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. 2022 Feb 10:6:6.
doi: 10.18332/ejm/145697. eCollection 2022.

Umbilical cord clamping and management of the third stage of labor: A telephone-survey describing Swedish midwives' clinical practice

Manuela Isacson  1   2 , Li Thies-Lagergren  3   4 , Paola Oras  5 , Lena Hellström-Westas  5 , Ola Andersson  1
Affiliations

Umbilical cord clamping and management of the third stage of labor: A telephone-survey describing Swedish midwives' clinical practice

Manuela Isacson et al. Eur J Midwifery. .

Abstract

Introduction: The timing of cord clamping impacts children's short- and long-term well-being. When making clinical decisions, midwives incorporate their tacit and professional knowledge, experience and current evidence. There appears to be a lack of knowledge regarding Swedish midwives' management of the third stage of labor and cord clamping practice. The aim of this study was to explore Swedish midwives' clinical practice concerning umbilical cord clamping and the third stage of labor in spontaneous vaginal births.

Methods: The study was designed as a cross-sectional telephone survey including 13 questions. Midwives were randomly selected from 48 births units in Sweden. Two midwives from each unit were interviewed. The primary outcome was timing of umbilical cord clamping practice in full-term infants. Secondary outcomes were the management of the third stage of labor including prophylactic use of synthetic oxytocin, the timing of cord clamping in preterm infants, controlled cord traction, uterine massage, and cord milking.

Results: Altogether, 95 midwives were interviewed. In full-term infants, all midwives preferred late cord clamping. Considerable heterogeneity was seen regarding the practices of synthetic oxytocin administration postpartum, controlled cord traction, uterine massage or cord milking, and cord clamping in preterm infants.

Conclusions: Midwives in Sweden modify recommendations regarding delayed cord clamping in a way they might perceive as more natural and practical in their daily, clinical work. The study revealed a reluctance toward the administration of prophylactic oxytocin due to fear that the drug could pass to the infant. An overall large variation of the management of the third stage of labor was seen.

Keywords: midwifery practice; prophylactic oxytocin; third stage of labor management; umbilical cord clamping; umbilical cord traction; vaginal delivery.

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Conflict of interest statement

The authors have each completed and submitted an ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. Li Thies-Lagergren reports that she is a board member of The Swedish Association of Midwives.

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