Preventing Postpartum Hemorrhage Using Expedient Judy’s 3,4,5 Protocol:
Retrospective Cohort Study
Abstract
Background: Postpartum hemorrhage was a deadly characteristic eliminated
by evolution. No animals hemorrhage. The first case of documented human
postpartum hemorrhage appears in the literature around 1400 AD. Human
PPH appears to be a relatively recent occurrence, perhaps coinciding
with the decrease in the use of squatting. A protocol called Judy’s
3,4,5 calls for squatting delivery of the placenta between 3 and 5
minutes postpartum. Methodology: A retrospective cohort study of 1,024
planned, attended homebirths in Israel using Judy’s 3,4,5 minute third
stage protocol compared to 2,691 planned homebirths resulting in vaginal
births in British Columbia using active management or expectant
management of the third stage of labor. Results: Among similar groups of
low risk births, active management, or expectant management resulted in
4.1% PPH over 500 cc, whereas Judy’s 3,4,5 minute protocol resulted in
0% PPH over 500 cc. Conclusion: Judy’s 3,4,5 minute protocol continues
to result in less blood loss than any other third stage protocol at
vaginal birth. The average blood loss is 100 cc for the first two hours
after the birth of the newborn.