Controlled cord traction is a component of active
management that is somewhat overlooked in the
research on third stage management. Two older trials
suggest that controlled cord traction is associated with
lower mean blood loss and shorter third stages
compared to less active approaches.29 These findings are
supported by a recent RCT which found a reduction of
postpartum hemorrhage in the controlled cord traction
group (5.8% vs. 11%; OR 0.50, 95% CI 0.15-0.63).52 The
results of this trial may be confounded by differences in
the timing and route of administration of oxytocin
between the study groups.