By DONALD G. McNEIL Jr.
Published: March 12, 2012
Delivery without pulling on the umbilical cord may be a simpler way to keep some women from bleeding to death in childbirth, a new study has found.
In Africa and Asia, postpartum hemorrhage kills a third of the women who die in childbirth, and health agencies constantly struggle to refine midwife training to prevent those deaths. (Above, a maternity ward in Sudan.)
Many midwives are now trained to deliver the baby, give the mother a shot of oxytocin to help her uterus contract, clamp the cord and pull steadily on it to get the placenta out. Then they massage the uterus to help it tighten and to cut off blood flow.
A study published by The Lancet last week looking at results from a trial of more than 24,000 women in eight countries found that pulling the umbilical cord — known as “controlled cord traction” — did not significantly reduce the amount of blood lost.
Pulling also carries a slight risk of tearing the cord and of causing a rare but life-threatening condition — uterine inversion, in which the organ is pulled inside out or even out of the body.
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