Worldwide, expectant management is frequently
practiced. The Global Network for Perinatal and
Reproductive Health conducted an observational, cross
sectional survey in 10 countries and concluded that the
rate of active management was 24.6%.58 This low rate
may be accounted for by women’s desire for a more
“natural” childbirth, a philosophy that active
management is unnecessary, and a preference to avoid
the potentially unpleasant effects of uterotonic agents.59
The lack of availability of uterotonics also limits the use
of active management in some countries.