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Preventing Postpartum Hemorrhage Using Expedient Judy’s 3,4,5 Protocol: Retrospective Cohort Study
  • Judy Cohain
Judy Cohain
Hebrew University
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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.