SECOND STAGE OF LABOUR

THIRD STAGE AND DELIVERY OF THE PLACENTA

"The third stage of labour is when the placenta or afterbirth comes away from the wall of the uterus, passes quickly down the vagina and is delivered.

Provided you have had a normal labour with no interventions (i.e. your labour wasn't induced or speeded up; you didn't have any kind of pain relief except gas and air, and you pushed your baby out into the world yourself) you could choose to have a natural or 'physiological' third stage.

Physiological third stage:

• After your baby is born, the midwife does not cut your baby's cord until it has stopped pulsating.
• She waits for your uterus to contract and push the placenta out.
• The placenta is delivered 10 to 20 minutes after the birth of your baby. It can sometimes take longer.

However, in many hospitals, it is routine to carry out a 'managed' third stage both for mothers who have had a natural birth and for those who have had interventions.

A managed third stage:

• As your baby's shoulders are being born, you are given an injection into your thigh of a drug called syntometrine.
• The midwife clamps and cuts the cord as soon as your baby is born.
• She watches the cord carefully and when she sees it lengthen, she knows that the placenta has come off the wall of the uterus.
• She then grasps the cord and draws the placenta out of the vagina.
• The placenta is delivered within 7 minutes of you giving birth.

The two methods don't mix

If you are having a natural third stage, there must be no interference at all with the cord, and your body must do all the work of expelling the placenta itself.

If you are having a managed third stage, your midwife must actively deliver the placenta.

If you have had any kind of intervention in your labour, a managed third stage would be safer for you."