THIRD STAGE – 5 to 30 minutes
During the third stage of labour, the placenta is born.
You may:
- Need a few minutes to collect yourself before focusing on your baby.
- Be surprised by the baby’s appearance – the body a bloody, greyish-purple colour, covered with a white substance (vernix), the irregular-shaped head.
- Be engrossed with your baby; be emotional, overwhelmed and cry.
- Not notice the birth of placenta.
In Your Body:
- The uterus contracts to enable the placenta to come away the from uterine wall. Contractions may be mildly painful.
- The placenta usually slips out in one to two pushes.
- The uterus contracts against exposed blood vessels from the former site of the placenta site to control bleeding.
The medical staff/midwife may:
- Ask you to push for birthing the placenta at the appropriate time.
- Invite your partner to cut the umbilical cord. Some believe the cord should be cut immediately, and others prefer to wait until it stops pulsating.
- Check baby’s condition immediately and evaluate it at one to five minutes after the birth to give the baby an Apgar score.
- Give the baby a Vitamin K injection to facilitate blood clotting.
- Dry and wrap baby to keep it warm.
- Give you a pitocin injection in your thigh (or through IV). This is a precautionary measure against excessive uterine bleeding.
- Examine the placenta and umbilical cord to make sure they appear normal.
- Take routine blood samples from the umbilical cord.
- Repair episiotomy incision, if applicable; repair tears if necessary (small tears are left alone).
FOURTH STAGE – first hours after the birth
You may:
- Be hungry, feel tired, elated and satisfied.
- Be mildly uncomfortable if an episiotomy has been performed.
Your baby may:
- Open her eyes and be alert and attentive to its parents (the ‘first period of reactivity’).
The medical staff/midwife may:
- Encourage the baby to breastfeed; this helps control uterine bleeding. Also, if the baby is breastfed within two hours after birth, it is more likely to breastfeed successfully in the coming weeks.
- Check the height and tightness of the uterus, vaginal bleeding and blood pressure.
- Put antibiotic ointment in baby’s eyes. (This can be delayed for an hour to allow the baby’s first glimpse of her parents.)
- Leave the new family alone for most of the first hour together. Every labour and birth is different. Your labour and birth may not proceed exactly as described – especially with regard to the timing of each stage.
No matter what kind of labour you have, congratulate yourself for your hard work – and the miraculous result.