Third Stage of Labor
Be Empowered Birth Series
The third stage of labor refers to the birth or expulsion of the placenta. Following the excitement of birth, the mother may feel surprised when her caregiver instructs her to “push for the placenta.” She may feel shaky or very emotional, and she may be either acutely aware that contractions have not completely subsided, or so engrossed with the new baby that she doesn't even notice them.
During this stage, the baby may be placed on mom’s chest and begin bonding with his parents. Breastfeeding may also be initiated at this time, when baby is alert and the suckling reflex is strong. Nipple stimulation through breastfeeding has the added benefit of increasing oxytocin, which helps the uterus continue to clamp down and expel the placenta. Following cord clamping (which may be delayed upon request to allow maximum blood flow from the placenta to baby), the birth partner may cut the umbilical cord. Many are surprised by how rubbery and slippery the cord feels- it takes some oomph to cut through the cord, but neither baby nor mom can feel this. If the parents have chosen to save cord blood for private storage or public donation, the caregiver will collect the blood at this time.
In hospital settings, the third stage is usually actively managed, meaning the caregiver encourages efficient delivery of the placenta by injecting Pitocin and/or gently tugging on the umbilical cord. In an expectantly managed third stage, the caregiver may wait up to 30 minutes or longer for spontaneously delivery of placenta before taking steps to encourage its expulsion. In both models, Mom will be encouraged to push gently to expel the placenta- as the placenta is gelatinous and soft, this is nothing compared to the hard work of birthing a baby!
Once the placenta is delivered, the caregiver will inspect the placenta to make sure none of it has been retained in the uterus, and examine the mother’s birth canal to determine whether stitches are necessary. The caregiver may also feel mom’s uterus to make sure it is clamping down effectively, and may provide fundal massage by vigorously rubbing the top of the uterus to help it contract. This can be very uncomfortable for mom. By law in the state of Texas, every mother has the right to keep her placenta (after all, it is her organ) for encapsulation, ritualistic use, or disposing of it in her own personal way.
Want to be prepared and empowered for your birth? Sign up for childbirth classes, where we discuss all of the elements of what to expect in labor, learn about the benefits and risks, and how to prepare for all the stages of labor!