What happens during the third stage of labour?

During the third stage of labour, your placenta will peel away from the uterine wall and your body will expel the placenta. Holding your baby skin to skin after birth and close to your breast releases oxytocin and helps this process.

What is happening

  • Cord can pulse for up to 3 minutes
  • Uterus contracts
  • Placenta peels away from uterus wall
  • Placenta is 'birthed'

What you can do

  • Push when you have the urge
  • Stand or squat to assist with birthing the placenta
  • Cut the cord
  • Put your baby on your naked chest after birth for skin to skin

You may need to find a different position than what you used in labour to push out the placenta, perhaps squatting, kneeling or standing may assist in the delivery. Your partner may want to assist with cutting the cord.

The cord can pulse for up to three minutes, which is called a placental transfusion. This cord blood carries the remaining blood from the placenta which can be up to a third of the baby's blood volume. This placenta transfusion helps activate the last major organ, your baby's lungs.

Some hospitals have a policy that you are required to have an 'actively managed' third stage instead of a natural third stage. In this case an artificial hormone is injected into you after your baby is born and the cord has been clamped. This helps the uterus to clamp down quickly and expel the placenta and is believed to reduce the risk of postpartum bleeding. However, it does deny your baby the remaining blood from the placenta.

A natural third stage is when you wait for the placenta to be expelled naturally. This can sometimes take up to an hour.

A compromise might be to allow the cord to finish pulsating and then clamp the cord and administer the injection.

During this time it is important to put your baby on your naked chest for some skin to skin contact to help the placenta peel away easily and quickly. 

You might feel a sense of shock at this time or feel overwhelmed which is very normal after what you have just been through. Try to focus on quiet skin to skin time with your baby for bonding and to help establish breast feeding.

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