08/31/2026
Expectant management is not just “not doing active management.”
It is its own skilled approach to the third stage of birth.
Evidence Based Birth describes expectant management as allowing the placenta to separate and birth without routine Pitocin or controlled cord traction, while still actively supporting normal physiology and watching closely for hemorrhage.
That requires skill.
It means knowing how to protect the hormonal environment that helps the uterus contract.
💗 Keep mom warm.
💗 Keep baby skin to skin.
💗 Support upright positioning when appropriate.
💗 Protect oxytocin and avoid unnecessary interruption.
💗 Watch blood loss and uterine tone closely.
💗 Know when physiology is working and when intervention is actually needed.
There are benefits and risks to both active management and expectant management.
Evidence Based Birth specifically recommends that families be counseled on both so they can make an informed choice based on their personal hemorrhage risk, birth circumstances, and preferences.
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