Our Director is expecting her third child in March 2010. Follow her journey to homebirth on the blog.

Stage III: Placenta Delivery

There are two critical events you must prevent in the placenta delivery stage:  early cord clamping and manual cord traction.  Once the baby is born, you are so delighted and overwhelmed with its presence and the emotional high you experience that it can be so easy to miss the cord being early clamped.  Since this is (misguided) routine procedure in most hospitals, the best prevention is to make your provider clear that it is against your wishes before the birth.  Even so, many will forget and habit will take over.  You must be ready to get between the doctor and the baby if need be to prevent the cord from being early clamped.


Manual cord traction occurs when the care provider is in a hurry and decides to "help" the placenta detach quickly by pulling on it.   As it sounds, this isn't a good idea.  It increases the risk of postpartum hemorrhage, which is the leading complication noted in birthing.  I've heard far too many stories of moms thanking their doctors for "saving them" from bleeding to death during birthing.  They swear that they would have died if they hadn't been in a hospital.  They never knew that their "care" provider was the one who caused the bleeding and that it was completely preventable!


The third stage is fairly anticlimactic for most. While you're holding your baby your care provider might remind you to push gently to help expel the placenta.


Sometimes the placenta delivery is delayed. Nursing your baby will help stimulate birthing embraces to help bring the placenta, because it will release natural oxytocin into your body. Coughing, sneezing and laughing can be used as techniques to help you expel the placenta.  Even a good hard cry to celebrate your baby's birth can do the trick.


WHAT & HOW YOU MAY FEEL

  • Indescribable Joy
  • Empowered
  • A Birthing "High"
  • Afterbirth sensations or contractions
  • Uncontrollable Shaking


BEHAVIOR & ATTITUDE

  • Tears of Joy
  • Uncontrollable Smiling


MANAGEMENT STRATEGIES

The placenta delivery doesn't need much management.  After a few hours, you might find that the afterbirth pangs require some breathing and relaxation techniques as your uterus begins to contract back down to its normal size.  Nursing is the best way to naturally stop postpartum bleeding (called "lochia") by helping the uterus contract.  Fundal massage, where a care provider presses on your uterus, can also be performed to slow bleeding and break up any clots.  However, this can be uncomfortable depending on the person doing it.  Nursing is more effective but if fundal massage is recommended, then you can ask someone to instruct you on how to perform it, and then do it yourself.


WHAT YOU MIGHT DO

  • Cry
  • Request Immediate Contact with the Baby
  • Nurse Immediately
  • Delay Newborn Procedures


WHAT YOUR Birth COMPANION MIGHT DO

  • Stay with You
  • Hold the Baby
  • Take Pictures
  • Make a Video

It is common to experience uncontrollable shaking after the placenta delivery.  This is just the body's normal reaction to the hormonal changes that take place after birth.  It can sometimes interfere with your ability to hold your baby.  It usually lasts only a few minutes and wrapping yourself with blankets from a warmer will help keep you comfortable until it subsides.


After the placenta delivery, you may wish to see or keep it.  Remember that some hospitals will sell your placenta if you don't claim it.  If you’re not okay with medical research on your placenta, then tell your care provider you want to dispose of it yourself. 


Planting the placenta is one option. You should dig a hole at least 16 inches deep and bury the placenta. You must wait a year before trying to plant a tree or anything over it because it will be too rich and may kill the plant.  You can save the planting for your baby's first birthday.


Best wishes and enjoy your new family!



References

Rabe H, Reynolds G, Diaz-Rossello J. Early versus delayed umbilical cord clamping in preterm infants. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD003248. DOI: 10.1002/14651858.CD003248.pub2.

Prendiville WJ, Elbourne D, McDonald S. Active versus expectant management in the third stage of labour. Cochrane Database of Systematic Reviews 2000, Issue 3. Art. No.: CD000007. DOI: 10.1002/14651858.CD000007.

Cotter A, Ness A, Tolosa J. Prophylactic oxytocin for the third stage of labour. Cochrane Database of Systematic Reviews 2001, Issue 4. Art. No.: CD001808. DOI: 10.1002/14651858.CD001808.






Giving Birth NaturallyStages of Labor: Placenta Delivery

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Disclaimer:  All information is provided for informational purposes only, although every effort is made to provide accurate and current information.  Unless otherwise noted, the site content & all online childbirth classes are not written by doctors or other health care professionals and is not intended to be or to substitute for medical advice, diagnosis, or treatment. You should always seek the advice of a physician, nurse, midwife or other health care professional regarding your individual medical questions and any particular medical treatment.

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