Labor’s third stage: exit placenta.
The third stage of labor which involves the birth of the placenta is an important yet often overlooked part of the birthing process. Midwives usually approach this stage with patience and mindfulness, understanding that the placenta's natural release is an essential part of a safe, physiological birth. We wait for the placenta to detach on its own, allowing the body time to complete the process without rushing. This respect for the body’s natural rhythms not only honors the birthing journey but also encourages optimal uterine contraction, which helps prevent excessive bleeding. While we remain vigilant for any signs of complications, such as heavy bleeding or failure to deliver the placenta, we support the body’s natural timing, which typically occurs within 30 minutes to an hour after the baby is born.
One key aspect of this stage is delayed cord clamping, which has been shown to have numerous benefits for the newborn. By waiting to cut the umbilical cord until it stops pulsating, the baby can receive the full amount of blood from the placenta, boosting iron stores and reducing the likelihood of anemia. In addition, the gentle transition from the placenta’s oxygen supply to the baby’s lungs is more gradual, supporting overall infant health. While we monitor the baby closely during this time, we do not rush the process, understanding that this moment is an opportunity for both mother and baby to begin their new life together in a calm, uninterrupted way.
If the placenta doesn't release naturally within a reasonable timeframe, active management may be considered. This involves gentle methods to encourage the placenta to detach, such as fundal massage or even manual removal if necessary. While this is rare in a healthy, uncomplicated birth, we are prepared to handle it if needed. The act of birthing the placenta also signals the uterus to contract, helping to close the blood vessels and reduce the risk of postpartum hemorrhage. The expected blood loss during this stage is typically about 200-300 ml, though it can vary. By allowing the body to complete this final step with respect and patience, we ensure that both mother and baby are supported physically and emotionally during the final phase of their birth journey.
