Novel third stage protocol https://www.youtube.com/watch?v=AAJPW4p6rzU reduces postpartum hemorrhage at vaginal birth.

Objective: To reproduce the absence of postpartum hemorrhage (PPH) experienced by all mammals except humans, in humans, by implementation of the 1, 2, 3 min expedient squatting protocol www.youtube.com/watch?v=AAJPW4p6rzU. The protocol prevents postpartum hemorrhage ≥ 500 mL after vaginal birth. It only requires a digital watch to precisely time 2 min.

Design, Setting, Sample And Methods: Mean blood loss and PPH rate are reported for 2,149 consecutive planned, attended vaginal births using the 1, 2, 3 min squatting third stage protocol.

Main Outcome Measures: Blood loss; PPH ≥ 1000 mL.

Results: Expedient delivery of the placenta in squatting within 3-5 min postpartum resulted in an average blood loss of 100 mL in the first 2 h after birth and no cases of PPH ≥ 500 mL in the first 24 h after birth. The lowest previously published PPH ≥ 1000 mL rate at vaginal birth is 4 %. The PPH ≥ 1000 mL using Active Management is 5 %.

Conclusion: Less bleeding occurs when women expediently push out the placenta within 3 min of the birth of the newborn, in squatting, taking advantage of the still open cervix, gravity, and the increased effectiveness of their diaphragm and abdominal muscles.