The mother has successfully gone through all of the phases of the first stage of labor, including early, active and transition. She has also completed the phases of pushing or second stage labor which entailed the resting phase, descent and then crowning and birth. The last notable stage of labor, the separation and expulsion of the placenta, is what is known as the third stage of labor.
What Happens in the Third Stage of Labor?
For most women, the third stage of labor is fairly uneventful. Once the baby is born, the mother can experience some cramps or discomfort when the placenta separates from the wall of the uterus. She may even have a little extra vaginal bleeding that her care provider will notice to signal this separation.
The mother may sense a "heaviness" in the third stage of labor. This can be a sign that it is time for her to push out her placenta. Or her provider may instruct her to bear down once he or she can tell that the placenta has separated. Pushing during the third stage of labor is not similar to pushing out a baby in the second stage. The placenta is soft and typically does not require much effort on the mother's part to expel. In fact, once the placenta is born, the mother typically will feel a sense of relief.
How Long Does the Third Stage of Labor Last?
The third stage of labor generally lasts from 10 minutes and up to 20 minutes after the baby is born. In most cases, the placenta separates easily, sometimes even without much pushing effort. On occasion, the birth of the placenta takes a bit longer, which is perfectly normal.
In rare cases, if the placenta is taking longer to separate on its own, the care provider may suggest using pitocin, manual uterine massage (known as fundal massage) or breastfeeding to help contract the uterus and expel the placenta.
What Can Support Team do to Help in the Third Stage of Labor?
During the birth of the placenta, most mothers do not need much instruction unless there is a specific reason to push. Since it is generally not a painful stage of labor and it only lasts for a few minutes, she may not need a tremendous amount of emotional support or reassurance unless the placenta is taking longer to be born.
Sometimes mothers get so distracted by the birth of the baby that they tend to "forget" that they have a little more work to do. So labor support people can provide gentle reminders that there is just a small job left to do and then her hard work of labor is over!
Birth Plan Options with the Placenta
In some cultures, the placenta plays a very significant part in the birth experience. Some families will decide to keep the placenta and burying it as a part of their birth plan, rather than throwing it away. Others may appreciate having a "tour" of the cord, sac and placenta or even take pictures of the placenta before it is disposed of. The provider will be able to show parents exactly where the placenta was attached to the mother and the baby's home for nine months.
Parents who are interested in doing anything different with the placenta ought to include this request in a birth plan and talk to their care providers prior to birth.
References:
Simkin, P., The Birth Partner, Harvard Common Press, 2008.
Lane, B., Kirsch, I., Knack Pregnancy Guide, Globe Pequot Press, 2009.
Brenda Lane - Brenda Lane is a published author, Lamaze certified childbirth educator, DONA certified birth doula and approved birth doula trainer.
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