“Retained placenta” becomes a problem when it causes a problem.
I’ve had third stages last upwards of 2 hours, and while the woman is well there is no need to rush things. By the same token, I’ve had women become unwell within a half hour, and don’t wait the last half hour to confirm that she is unwell with a retained placenta.
The “evidence” is based on data from India and Africa, where women have to travel hours to hospitals if the placenta is still in situ. Even then, mortality and serious morbidity rates are 9-11%. There is no evidence that a third stage of longer than 60 minutes is dangerous in a high income setting.
Your page is a great resource to teach with, but I’m so sorry that there are so many women who have a horrid story to tell. Please know there are a band of us working towards reclaiming Midwifery and feminine wisdom, and we hope one day your page is something from the history books only. Keep up the good work, and we will keep up the fight xx