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Third Stage of Labour
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The third stage of labour is the delivery of your Placenta (afterbirth) and the membranes that your baby has been protected by for the past nine months. There are two different ways to deliver the placenta either Active management or a Natural (Physiological) management.
Active Management
Active involves you being given an injection of an oxytocic drug (commonly syntometrine) as your babies' shoulders are being delivered. When your baby is born the cord will be clamped and cut and the placenta is then delivered by the midwife pulling the cord gently until the placenta and membranes are delivered.
Advantages of an active third stage include:
- You may have less bleeding, however some more recent evidence disputes this.
- You will be recommended to have an active third stage if you have had any intervention in pregnancy for example induction, assisted delivery or epidural because these interventions can prevent your uterus contracting effectively after the birth therefore you are more likely to bleed heavier.
- The placenta is usually delivered within 10 minutes of the baby being born.
Disadvantages include:
- You may feel nauseous of vomit afterwards
- It can cause headaches and raise your blood pressure. The side effects have normally worn off after a couple of hours.
Physiological third stage
With a physiological third stage your placenta is just left to separate naturally without the need for any drugs or intervention from the midwife. Your uterus will continue to contact and you can push down to deliver the placenta. If you have not had any drugs or intervention throughout your labour you may favour this.
Advantages include:
- Natural
- No side effects
Disadvantages include:
- It can take longer. On average a physiological third stage can take between 15 and 60 minutes but in some cases it can take up to two hours. You can try and speed up the delivery by sitting upright to let gravity work and cuddling or breastfeeding your baby.
- Some research does suggest that you may bleed heavier, however more recent evidence says that your bleeding may be less in the postnatal period if you have physiological management of the third stage of labour.
