Stages of labour
Third stage of labour
After the birth of your baby, your uterus gently contracts to loosen and push out the placenta. This may occur five to 30 minutes after the birth of your baby.
The muscles of the uterus continue to contract to stop the bleeding. This process is always associated with a moderate blood loss – up to 500 millilitres. In this stage of labour, one of the potential problems is excessive bleeding (postpartum haemorrhage), which can result in anaemia and fatigue. This is why the third stage is carefully supervised.
There are two approaches to managing the third stage:
- natural (also known as physiological or expectant) management, or
- active management.
Natural third stage
What is a natural third stage?
A physiological or natural third stage means that you wait for the placenta to be delivered naturally.
After your baby's birth, your midwife will delay clamping the umbilical cord to allow oxygenated blood to pulse from the placenta to your baby.
Your uterus (womb) will contract, and the placenta will peel away from the wall of your uterus. The placenta will then drop down into your vagina, ready for you to push it out.
Delayed cord clamping
For baby
The benefits of delayed cord clamping for the baby include a normal, healthy blood volume for the transition to life outside the womb; and a full count of red blood cells, stem cells and immune cells which results in higher iron stores in the baby for up to six months.
For mother
Delayed clamping keeps the mother-baby unit intact and can prevent complications with delivering the placenta.
Active (or managed) third stage
Benefits of an active third stage
The advantage of an active third stage is the lower risk of very heavy bleeding immediately after the birth. Your midwife or doctor will recommend you have an active third stage if you had complications during pregnancy or labour, such as:
- twin pregnancy
- polyhydramnios
- heavy bleeding during pregnancy or in labour
- a history of retained placenta
- a low-lying placenta
- anaemia
- an induced or very long labour
- an assisted birth or caesarean birth.
Active third stage
Immediately after the birth of your baby, the midwife or doctor gives you (with your consent) an injection of oxytocin, clamps and cuts the umbilical cord, and then carefully pulls on the cord to speed up delivery of the placenta.
Modified active third stage
This is a combination of active and natural. It is similar to active third stage but it includes delayed cord clamping.
In this guide:
- Baby’s journey of labour
- Hormones during labour
- Stages of labour
- First stage of labour
- Second stage of labour
- Third stage of labour
- The fourth stage