{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T19:52:33Z","timestamp":1774381953168,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,1,31]],"date-time":"2018-01-31T00:00:00Z","timestamp":1517356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Midwives and physicians incorporate their knowledge, experiences, and other variables in making clinical decisions. Variations in the management of the third stage of labor may be a result of variables that influence providers\u2019 decision making. The purpose of this study was to describe variables that influence US midwives\u2019 and physicians\u2019 management of the third stage of labor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A randomly selected national sample of certified nurse\u2010midwives and certified midwives, certified professional midwives, obstetricians, and family physicians was surveyed about the extent to which maternal characteristics, maternal history, and current birth characteristics influence their third\u2010stage management. The extent of influence was defined in terms of always to never altering management. Descriptive summaries, group comparisons, and partial correlations were used to determine differences in influences between midwives and physicians. One free\u2010text question was analyzed using qualitative methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1243 clinicians responded. There was considerable variability in the response patterns in that the same variable was reported to always alter management during the third stage of labor for some participants yet did not influence the management practices of others at all. Differences between responses from midwives and physicians were explored as a possible explanation for some of the variability. In response to the free\u2010text inquiry about variables that most influenced changes in participants\u2019 usual management of the third stage, the participants most often included active bleeding, current recommendations or guidelines, and maternal or family preferences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This study identifies variables reported as influencing clinical decision making during the third stage of labor. Therefore, these variables are important to consider when evaluating interventions and outcomes related to management of the third stage of labor and any attempts to design new interventions. The findings are descriptive of practice; they are not intended to guide changes in practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jmwh.12728","type":"journal-article","created":{"date-parts":[[2018,1,31]],"date-time":"2018-01-31T22:31:59Z","timestamp":1517437919000},"page":"446-454","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Variables That Influence US Midwife and Physician Management of the Third Stage of Labor"],"prefix":"10.1111","volume":"63","author":[{"given":"Mavis N.","family":"Schorn","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary S.","family":"Dietrich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beth","family":"Donaghey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann F.","family":"Minnick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-017-1511-5"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1258\/jrsm.2010.100104"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-015-3366-7"},{"issue":"1","key":"e_1_2_8_5_1","article-title":"Barriers to and facilitators of evidence\u2010based decision making at the point of care: Implications for delivery systems, payers, and policy makers","volume":"1","author":"O'Malley AS","year":"2016","journal-title":"MDM Policy Pract"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-0882-3"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.07.007"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001810"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002351"},{"issue":"3","key":"e_1_2_8_10_1","first-page":"CD007412","article-title":"Active versus expectant management for women in the third stage of labour","volume":"2015","author":"Begley CM","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5514.622"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.297.6659.1295"},{"issue":"1","key":"e_1_2_8_13_1","first-page":"76","article-title":"International Federation of Gynaecologists and Obstetricians. 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