Delivering the placenta is the third and final stage of having a baby.

You’ve made it through your pregnancy and the big delivery, and now you’re holding your precious newborn baby. You might be thinking, “Glad that’s over!” But actually you’ve entered the final stage of delivery.

The third stage of childbirth is the delivery of your placenta. And while it may seem anticlimactic compared to meeting your little bundle of joy, this stage of labor and delivery is very important and symbolic for many mothers. 

During pregnancy, the placenta provides everything the baby needs, including nutrition, water and oxygen. It also removes what isn’t needed, like waste products and carbon dioxide. The delivery of the placenta represents the end of an important era living in the safety of your womb. It’s the beginning of a new stage of life “on the outside.” 

The placenta is a disk shaped organ attached to the mother’s uterus on one side and the baby’s umbilical cord on the other. It has two sides. The maternal side is usually dark red in color, while the fetal side is almost translucent in color and shiny. The doctor will examine the delivered placenta to ensure each side appears the way it is expected to. 

How is the Placenta Delivered During Vaginal Birth? 

With a vaginal delivery, the uterus will continue to contract after the baby is out. These contractions move the placenta forward for delivery. Mercifully, these contractions aren’t typically as strong as labor contractions, and some women don’t even feel them (if you can believe that!). Your doctor might press on your stomach or ask you to push to help move the placenta forward. Typically, the placenta delivery is quick, happening within five minutes after the baby is delivered. But it can take longer for some women. 

Some women report being so focused on their baby for the first time that they don’t notice the placenta delivery. Others, however, observe an additional gush of blood after delivery that’s followed by the placenta.

How is the Placenta Delivered During Cesarean Birth? 

If your delivery is via c-section, your doctor will physically remove the placenta from the uterus before closing the incision in the uterus and your stomach. 

Active Management Vs. Physiological Management During the Third Stage of Labor

Generally, there are two options for how you complete the third stage of labor: active management and physiological management. But a combination of both may also be used. 

Active management uses an injection of a drug called syntocinon or ergometrine in your thigh soon after the baby’s birth. This speeds up the delivery of the placenta, usually happening within 30 minutes of birth. This is the recommended method, as it lowers the risk of heavy blood loss.

Physiological management is generally used in midwife-led units and home births. This gets the placenta to come out mainly by pushing, gravity, contractions and sometimes nipple stimulation. It does not include the use of oxytocin injections and can take up to one hour. 

What is a Retained Placenta?

The placenta should be delivered within 30 to 60 minutes after having the baby. If it isn’t delivered or doesn’t come out in its entirety, this is called a “retained placenta.” There are many reasons the placenta may not fully deliver. The cervix may have closed and is too small for the placenta to move through. The placenta may be too tightly attached to the uterine wall. A portion of the placenta may break off and remain during delivery. 

Retained placenta is a major issue because the uterus needs to clamp back down after giving birth. Tightening of the uterus helps blood vessels inside to stop bleeding. Therefore, if the placenta is retained, you may experience bleeding or infection. Your doctor will work with you on your best options to remove the placenta entirely.

If you’re pregnant or planning to get pregnant, contact us today to discuss your birth plan! We are here to help and answer any questions you may have.

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