Active vs expectant management of 3rd stage

[MyThumbsHaveGoneWeird]

Please help me make a decision on this. I am finding it impossible!

My instincts are that if I have had an intervention free labour and birth I would prefer to remain intervention free and have delayed cord clamping and a natural 3rd stage. But then I think is it really sensible to demand to go against about 30 years of standard practice, when there is good evidence that it does reduce post partum haemorrage here and BMJ 1988 and lancet 1998.

But then I read things like this(bottom right of page) which make me wonder about all those other studies and whether the conditions they were conducted in would be different to mine. A natural 3rd stage seems to cause less nausea and vomiting, less neonatal jaundice, and less chance of retained placenta. But am I just looking for evidence to support this because I am generally anti-intervention? Do these things outweigh the increased risk of PPH? If I do manage to have an intervention free labour and manage to start breast feeding quickly (big ifs I know) then does that put me into a very low risk group and therefore make the above PPH studies less applicable?

I really need to discuss this with you all to get my head straight!

I had a HB with natural third stage.

The literature did seem more on the side of active management at first sight but on closer reading I found that my own understanding of a physiological 3rd stage didn't match that used in many of the studies. I had no pre-existing risk factors and knew that HB and low levels of intervention are associated with lower incidence of PPH.

I therefore decided on a wait and see approach. The syntometrin was there just in case.

In the event my bleeding was minimal and the placenta came out intact with one push after 10 mins of skin to skin. No management was needed.

Syntocinon I meant to say, not syntometrin.

Thanks so much for your answer mintpurple. I think you're right, while I might hanker after delayed cord clamping and to not have it cut til it stops pulsing etc etc as my ideal, I think the reason my son had a brutal start in life was not so much due to the managed third stage but because he was left undressed and hungry overnight in a cot next to me while I was completely away with the fairies after they sent my hubby home. I will always feel guilty about that and I think a future babe would do better to have me conscious and a managed third stage.... Thanks again.