The Third Stage of Labour

Have you ever wondered why expectant mothers experiencing contractions 10 minutes after giving birth? These painless contractions are signs of the placenta separating from the uterus. This third stage of labour is also referred to as the after birth or placental stage (the delivery of the placenta). 

During vaginal delivery, immediately the doctor sees the baby’s shoulder, the mother’s leg is injected with a contracting drug to speed up the separation. 

In the case of caesarean delivery, the placenta is taken out right after the umbilical cord is cut. The mother is then stitched up. 

Some of the concerns you may have during this stage are such as:

  • Postpartum Haemorrhage (PPH)

Postpartum haemorrhage is excessive bleeding that occurs in mothers after childbirth. See what to expect 24 hours after delivery here.  Postpartum haemorrhage is more common with caesarean births. It is the number one cause of maternal mortality. The causes of PPH may include:

  1. Blood clot problems
  2. Ruptured uterus
  3. Hematoma
  4. Deep tear in the tissues of the vagina or perineum

The best treatment of PPH is replacing the lost blood and fluid after stopping the bleeding by use of a Bakri balloon.

  • Uterine Inversion

Uterine inversion occurs when the uterus is partially or completely turned inside-out. There are four types of inversions namely:

  • Total inversion
  • Prolapsed inversion
  • Complete inversion
  • Incomplete inversion

The causes are not known, however, the following are risks associated with it:

  1. Weak uterus
  2. Usage of muscle relaxants during labour
  3. Short umbilical cord
  4. Pulling the umbilical cord too hard, trying to remove the placenta

Treatment can be through blood transfusion and intravenous fluids.

  • Retained Placenta

Retained placenta occurs when the placenta, or part of it, remains in the womb for more than 30 minutes. If left untreated, it may cause infection and/or excessive blood loss. There are three types of retained placenta namely:

  • Trapped placenta
  • Placenta accreta
  • Placenta adherens

Symptoms of retained placenta include:

  1. Heavy bleeding
  2. Fever
  3. Severe pain
  4. Discharge of foul-smelling tissues from the vagina

Treatment is through removal of the entire placenta or emergency surgery, depending on the severity of the complication.

Once through with the placental delivery, the midwife examines the placenta and membranes to make sure that nothing is left behind inside the womb. The mother can then relax as they await going home.

In caesarean, suction is done vaginally to remove any tissue that might still be inside. Complications arising from C-section are rare and may include:

  • Reaction to anaesthesia or medication used
  • Blood clots in the legs or lungs
  • Organs surrounding the uterus might be damaged during the surgery
  • Endometritis 


#Please note that development differs from one child to another. 

#Content intended for educational purposes only, and not a substitute for medical advice from your doctor.

Be careful when using any products mentioned on this website. We hold no regulations for such products or their providers.

Last reviewed January 2019

Sources: healthline, healthline, parentinghealthybabies

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