Objective: The purpose of this study was to discover whether performing a routine prior-to discharge ultrasound after manual exploration of the uterine cavity identified findings that led to interventions and reduced postpartum complications. Design: Retrospective multicenter cohort study was conducted between 2013 and 2019. Setting: Tzafon medical center and Emek medical center, Israel Population or Sample: Among 1780 women, who underwent manual exploration of the uterine cavity, 784 belonged to the routine ultrasound group and 996 belonged to the clinically indicated ultrasound group. Methods: A comparison was made between two medical center’s protocols according to which all women underwent a routine ultrasound after manual exploration of the uterus prior-to discharge (Tzafon medical center protocol) versus performing ultrasound only if clinically indicated (Emek medical center protocol). Main outcome Measures: The primary outcome included a composite of late post-partum hemorrhage, endometritis, uterine curettage and hysteroscopy to remove products of conception. Results: In comparison between the routine ultrasound group and the clinically indicated ultrasound group, more women had abnormal sonographic findings ((74 (9%) versus 20 (2%), respectively; P=0.0001), more interventions, particularly uterotonics administration (34 (4%) versus 6 (0.6%), respectively; P=0.0001) without a different in the composite outcome (27 (3%) versus 41 (4%), respectively; P=0.46). Conclusion: Conducting prior-to discharge ultrasound scan routinely after manual exploration of the uterine cavity led to more interventions without benefit regarding long-term outcomes. Therefore, this study supports conducting an ultrasound after manual exploration of the uterus only if clinically indicated.