In this randomized controlled trial, the lower abdomen was cooled by placement of an 8.6˚Cicepack during the first 2 h after placental delivery. The primary outcome was measured asthe total blood loss within 2 h after delivery. This study had 80% power at the two tails of5% significance level to detect the mean difference (MD, 70 g) in total blood loss within 2 hafter delivery between the two groups. The sample size was calculated as 144 women (72women per group).