08/01/2024
Welcome back to our first Midwifery Monday of the year! I hope everyone had lovely time off for the holidays, enjoyed a reset and are slowly easing back into the New Year. Also, massive congratulations to all new parents that had their babies over the festive period.
Today we are back to talk about the final stage of labour. Third stage starts once the baby is born and involves birthing of the placenta if youāre having a va**nal birth. If you are having a caesarean section, placenta is removed from the uterus by obstetrician performing the surgery. This stage can be managed actively ā with use of oxytocic drugs (they make your uterus contract) or physiologically with no drugs. The decision which way youād like third stage to be managed should be explored and discussed during pregnancy and with your midwife/obstetrician. There might be cases where physiological management wonāt be recommended.
During active management, you will be offered an oxytocic drug as soon as the baby is born, usually administered via injection into your thigh, to help your uterus contract, deliver the placenta through the birth canal and help control postpartum bleeding. Once there are signs that placenta has separated from the uterus, the midwife/obstetrician will gently pull on the cord, while having one hand on your tummy and guide the placenta out. This process usually lasts up to 30 minutes.
During physiological management, no drugs are administered, and you wait for the placenta to separate from the uterus on its own and thereās no guidance from the third person. A lot of women would feel sensation of pressure in their va**na and urge to push the placenta out themselves. This process usually takes up to 1 hour. In case of heavy va**nal bleeding during physiological management, your care provider might recommend to switching to active management to control the bleeding.
Have you thought about your third stage of labour?
Your āknow your stagesā midwife Sandra x
Ref: NHS. (2023) āThe stages of labour and birthā, https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/the-stages-of-labour-and-birth/