I'm hoping that Alan might be able to jump in on this.

I had my midwife appt this week, and she asked if I wanted a physiological or managed third stage. Now we are storing cord blood - so it doesn't really apply to me BUT I had a conversation with my mother about both choices (she's a MW) after having the same conversation with my MW and I was very disappointed to hear of my mum's lack of knowledge AND her giving out incorrect advice to her patients.

She claims that a physiological third stage causes more manual removal of placenta and PPH

Now I happen to agree in part that a physiological third stage leaves the 30% that Synto would have stopped hemorrhaging open to the PPH HOWEVER I can't believe that a physiological third stage would cause more manual removals??????? Wouldn't this be because the Synto was too efficient and didn't allow the placenta to pass before closing the cervix?

I'm confused and would like clarification hopefully in the way of a study I can point her to.

To be adamant you know best is great - but I wish she'd get her facts because many women are delivered by my mother on a weekly basis and I'd hate to think of the experience they're getting at the hands of her out of date, old school information