Is it painful to deliver the placenta?

Usually, women experience only period-like cramps, which are not that painful in comparison with earlier contractions.

What if I cannot expel the placenta?

In case the placenta is not expelled, the doctor may be obliged to perform additional actions, including manual ones.

Can breastfeeding assist during the third stage of labour?

Yes, the process of breastfeeding or skin-to-skin contact releases the natural production of oxytocin that causes your uterus to contract and aids in placental delivery.

Third Stage of Labour: Placenta Delivery & What to Expect

Following the effort of the second stage of labour and the joy of meeting your baby, there is one more step during labour, which is the delivery of your placenta.

What Is the Third Stage of Labour?

The third stage begins when your baby is delivered and ends after you deliver the placenta, which is known as the afterbirth. In the third phase of labour, your uterus contracts further, and the placenta is pushed out of your uterine walls. Your doctor closely observes your bleeding and the contractions in your uterus. The third phase is the shortest of the three phases and lasts from five to thirty minutes.

How Is the Placenta Delivered?

A few minutes after giving birth to your baby, you will have contractions in your uterus, although the contractions will not be as strong as the ones felt in the labour process; they may feel like menstrual cramps. Contractions help detach the placenta and move it down in preparation for delivery.

Your doctor may ask you to push one more time, or manually detach the placenta by applying gentle pressure to your abdomen. After the placenta is delivered, it is examined by the doctor in order to ensure that it was separated in one piece, because any left-behind pieces may cause problems.

Sometimes the placenta may fail to detach from the walls of the uterus, as well as fail to be expelled from the uterus. It is referred to as a retained placenta. It results in considerable loss of blood if left untreated. The treatment involves administering more medicine to make the uterus contract to allow the expulsion of the placenta. In some cases, a regional anaesthesia such as an epidural or general anaesthesia is required for the surgical removal of the placenta.

Active Management vs Physiological Management

There are generally two approaches to delivering the placenta, and your doctor can discuss these with you in advance so you know what to expect.

Active management: Your doctor gives you an injection, commonly in your thigh area, immediately after the birth of your child. This tends to make the third stage faster and can reduce the risk of heavy bleeding. The umbilical cord is also usually clamped with this approach.
Physiological management: The placenta comes out naturally and without any medications, using your natural contractions, and maybe even breastfeeding if required. It does take more time and is recommended for those women having a straightforward and uncomplicated labour process.

Both approaches are considered safe, and your doctor can help you understand which one suits your situation best, especially if you want to include a preference in your birth plan.

What Does Your Doctor Check After Birth?

As your body prepares to deliver the placenta, you would normally have the baby in your arms and on your chest. Some hospitals prefer to give you this bonding time by delaying the routine examinations of your baby for some time. As for the doctor, he or she will:

Check the level of your bleeding to ensure it does not exceed a normal level
Ensure that your uterus is contracting properly to reduce bleeding
Make sure that there are no tears in your body requiring stitching
Observe the breathing, colouring, and reactions of your baby

Once the placenta has been delivered and the stitches are done, you will be taken to a recovery room where you can further bond with your baby and try feeding.

When Should You Contact Your Doctor?

You will be under close supervision by your doctors at this stage; however, let them know when you experience any of the following symptoms, both right away and over the next several days:

Unusually heavy bleeding that does not stop
Pain that feels severe and unusual compared to normal afterpains
Fainting spells and dizziness
Uncertainty as to whether you have delivered the entire placenta
Any symptom that you simply feel is wrong

Your doctor has been specifically trained to spot all these signs; however, only you know your body well enough.

Even though this last stage might be short, it is quite crucial in the transition from the labour process into post-delivery. With the placenta delivered and first checks done, you can finally enjoy your baby's presence.

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FAQs on Giving Birth: The Third Stage of Labour Explained

Is it painful to deliver the placenta?
Usually, women experience only period-like cramps, which are not that painful in comparison with earlier contractions.
What if I cannot expel the placenta?
In case the placenta is not expelled, the doctor may be obliged to perform additional actions, including manual ones.
Can breastfeeding assist during the third stage of labour?
Yes, the process of breastfeeding or skin-to-skin contact releases the natural production of oxytocin that causes your uterus to contract and aids in placental delivery.