Delivering the placenta

Delivering the placenta

After your baby is born, your midwife should check how you are. The placenta (which is also known as the afterbirth) will be delivered or pushed out. This is called the third stage of labour. You can usually hold your baby during this stage if you want to.

When you were pregnant, a midwife should have explained to you about the 2 options for the third stage, and about the pros and cons of each. They are called active management and physiological management.

Active management

Physiological management

Injection of a drug called oxytocin into your thigh, usually as you give birth

No injection is given

The cord is clamped and cut between 1 and 5 minutes after the birth

The cord is clamped and cut once it has stopped pulsing

The placenta is pulled out by the midwife once it has separated from the wall of the uterus (womb)

You push the placenta out with contractions, which can take up to 1 hour

Active management speeds up delivery of the placenta, which will usually happen within 30 minutes, and lowers the risk of heavy blood loss (haemorrhage). But the injection does increase the chances of nausea and vomiting.

Your midwife should discuss these options with you again in the early stage of labour. You should be advised to have active management of the third stage, but should also be asked about your preferences. If you have a low risk of heavy blood loss, you may opt to have physiological management.

If you choose physiological management but your placenta is not delivered within 1 hour, or you have heavy blood loss, you will be advised to change to active management. You can also choose to change from physiological to active management at any time.

See later for what should happen if the placenta is not delivered.

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