The Third Stage

Once your baby’s been born, your uterus rests for about 15 minutes. But soon it starts to contract again to deliver the placenta. This is the third stage of labor, and it is comparatively painless-you’ll be so absorbed in your baby that you’ll probably hardly notice it.

The Third Stage

During the third stage of labor, the placenta becomes detached from the wall of your uterus and is delivered down the birth canal. The large blood vessels running to and from the placenta, which are about the thickness of a pencil, are simply torn across. Despite this, bleeding is rare because the muscle fibers of the uterus are arranged in a crisscross fashion so that when the uterus contracts down, the muscles tighten around the blood vessels and prevent them from bleeding. This is why it’s absolutely essential that your uterus contracts down into a hard ball once the placenta has been expelled. Massaging every now and then for an hour or so after the third stage is complete can help keep your uterus tightly contracted. Normally the third stage lasts about 10-20 minutes.

Delivering The Placenta

Usually your doctor or midwife won’t try to deliver the placenta until there are clear signs that it’s separating from the wall of your uterus and moving downward into your vagina. The signs your attendants will look for are contractions starting up again a few minutes after the birth of your baby, which shows that the placenta is about to separate, and your desire to bear down-this also shows that the placenta has separated from the wall of your uterus and is pressing down on your pelvic floor.

Once these signs have appeared, your doctor or midwife may encourage the delivery of the placenta by pulling gently on the cord, at the same time pressing above the rim of the pelvis to control descent. You may be asked to push. The placenta is expelled from your vagina, followed by the membranes. Rarely, a blood clot will also be expelled.

How you can help It may take up to half an hour before the placenta arrives. You can help speed things up by breastfeeding your baby because the sucking action stimulates your uterus to contract, thereby helping to expel the placenta. If your baby isn’t ready to suck, stimulating your nipples with your fingers can have the same effect.

Delivery The placenta may pass through your vulva in two different ways. In the first, the center of the placenta comes out first, dragging the membranes behind it. In the second, an edge of the placenta presents first, then it slips out of the vulva sideways. Most women want to see the placenta-it’s an amazing organ that’s been the life-support system for your baby for nine months.

After delivery Once the placenta is delivered, medical staff will check it carefully to make sure it’s complete and none of it has been left behind. If any of the placenta has been left in the uterus it can cause hemorrhaging later on, so it must be removed as soon as possible. If there’s any doubt, you may have an ultrasound scan to see whether the uterus is completely empty. The membranes should form a complete bag except for the hole through which your baby has passed. Your midwife will also check the cut end of the cord to make sure that the umbilical blood vessels are normal. After the placenta is delivered, the whole of your vulval outlet will be examined carefully for tears. Anything other than a minute one will be stitched immediately.

After The Placenta Is Delivered

After the uterus is completely empty and the placenta is delivered, Pitocin is usually given by intravenous infusion. The Pitocin helps the uterus contract and reduce the amount of bleeding. Blood runs through sinuses in the uterus, and when the uterus contracts down to a small ball, these sinuses are closed off. If the uterus does not contract well, you will continue to bleed. At At this point your doctor will start an IV (if you don’t have one already) and give you Methergine to control postpartum hemorrhage and help the uterus tone up. If you have high blood pressure, your doctor can give you a prostaglandin, which will have the same effect as Methergine to stop postpartum bleeding.

Oxytocin The hormone oxytocin is naturally produced by your body when you see and touch your baby and put her to your breast. This natural production of oxytocin helps control excessive bleeding and tone the uterus. At the same time, both you and your newborn benefit from close, skin-to-skin contact.

How You Will Feel

You may find yourself shivering and shaking after the placenta is delivered. After delivery of my second child, I was shivering and my teeth were chattering so much that I couldn’t speak or breathe properly. My own explanation for this is that for nine months I had a little furnace inside me, producing quite a lot of heat, and my body had adjusted to take account of the extra heat by turning my own thermostat down slightly. When my baby left my body, I was deprived of that heat and my body temperature probably dropped a few degrees. The only way the body can raise. Its temperature is to generate heat through muscular work. That’s exactly What shivering does-rapid contraction and relaxation of muscles produces body heat. The shivering usually stops in about half an hour, during which time your body temperature is back up to normal and your own thermostat is reset.