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    CARE DURING THE THIRD STAGE OF LABOUR: A POSTAL SURVEY OF OBSTETRICIANS AND MIDWIVES IN THE UK

    1D. Farrar, 2D. Tuffnell, 2R. Airey, 2H. Howarth, 1L. Duley. 1Leeds Institute of Genetics and Health Therapeutics, Division of Epidemiology and Biostatistics, University of Leeds, Leeds, UK, 2Bradford Institute for Health Research, Bradford Teaching Hospitals, Bradford, UK

    Background: Active management is use of a prophylactic uterotonic drug, cord clamping and controlled cord traction. Uterotonic drugs reduce the risk of postpartum haemorrhage, but the effects of other components remain unclear. Optimum timing for cord clamping is particularly controversial, with National Institute for Health and Clinical Excellence (NICE) offering different recommendations to World Health Organization (WHO), ICM and Federation Internationale de Gynecologie Obstetrique (FIGO).

    Methods: Postal questionnaire of 2230 fellows and members of the Royal College of Obstetricians and Gynaecologists (RCOG) and 2400 members of the Royal College of Midwives (RCM) in the UK. The questionnaire asked about current practice and views of care during the third stage.

    Results: RCOG: 1176 (53%) responded of whom 911 were conducting births: 94% (852/911) “always or usually” use active management: 66% (602/911) give the uterotonic with the anterior shoulder, 78% (714/911) use intramuscular syntometrine; cord clamping within 20 seconds by 73% (669/991) for term births and 56% (513/911) for preterm births; 94% (854/911) use controlled cord traction.

    RCM: 1445 (61%) responded of whom 1125 were conducting births: 71% (804/1125) ) “always or usually” use active management: 33% (369/1125) give the uterotonic with the anterior shoulder, 86% (968/1125) use intramuscular syntometrine; cord clamping within 20 seconds by 40% (447/1125) for term births and by 54% (604/1125) for preterm births; 94% (1050/1125) use controlled cord traction.

    More than 80% of both groups thought more evidence from randomised trials needed, timing of cord clamping was the most popular question.

    Conclusions: Initial data suggest most obstetricians and midwives report using active …

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