Carbetocin is an alternative synthetic oxytocin-receptor agonist available in Canada, the United Kingdom, and other countries,but not the United States. A large multinational randomized noninferiority trial (N=29,645) found that carbetocin was noninferior to oxytocin for prevention of postpartum hemorrhage and need for additional uterotonic agents after vaginal delivery. Carbetocin has a longer duration of action than oxytocin, eliminating the need for prolonged infusion.