The 3rd stage of labour begins from the moment the baby is born until the delivery (or expulsion) of the placenta, cord and membranes (or the 'afterbirth') from the woman's uterus.
In the majority of cases, the 3rd stage is actively managed by the caregiver. This involves the woman being given an injection of a synthetic
oxytocin hormone drug (called 'Syntocinon'), the umbilical cord being clamped and cut usually within minutes after the birth, and the cord being gently pulled (while the caregiver uses their other hand on the woman's belly to support her uterus) to help deliver the placenta.
Some women will choose to deliver their placenta using their body's natural processes. This is known as a natural or 'physiological' 3rd stage. Caregivers will often refer to this as 'expectant management'. This happens more often in birth centres and homebirth.
To understand the differences between a natural and an actively managed 3rd stage and what can be involved, we will first outline the natural physical process that the woman's body undergoes to expel her placenta unaided.