Postpartum haemorrhage (PPH) is one of the major contributors to maternal mortality and morbidity worldwide. Active management of the third stage of labour has been proven to be effective in the prevention of PPH. Syntometrine is more effective than oxytocin but is associated with more side effects. Carbetocin, a long-acting oxytocin agonist, appears to be a promising agent for the prevention of PPH. The use of carbetocin, being an important agent in the prevention of PPH, also increases its prevalence. It is planned to investigate the advantages and disadvantages of the timing of its use.

Inclusion Criteria:

• Singleton pregnancy
• Vaginal delivery at or beyond 38 weeks of gestation
• Primipar

Exclusion Criteria:

• Multiparity
• Contraindications to carbetocin use (e.g., pre-existing hypertension, pre-eclampsia,asthma, cardiac, renal, or liver disease)
• High-risk factors for primary postpartum hemorrhage, including grand multiparity,presence of uterine fibroids, or a need for prophylactic oxytocin infusion
• Anemia or
• body mass index (BMI) over 35
• Baby weight over 4000 grams
• Comorbidities or chronic diseases
• History of curettage
• Use of propess or oxytocin during labor