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If you have a history of haemorrhage, wish to donate cord blood or you request it, you can be given an oxytocic medication to actively manage the 3rd stage of labour. |
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If having a natural 3rd stage, depending on your wishes, your caregiver will either wait until the cord stops pulsating or wait until the placenta is delivered before placing clamps onto the cord. |
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The cord will be cut using surgical scissors by the caregiver or by the nominated person mentioned in your birth plan. |
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Your caregiver will remove the metal clamp (the one closest to the woman, leading from the placenta) so that the cord blood can drain into a receptacle. |
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Cord blood is collected if the woman has a negative blood group. |
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If donating cord blood your caregiver will actively manage the 3rd stage by administering an injection of oxytocic drugs and clamping and cutting the cord soon after the birth. |
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Your caregiver will wait during the natural rest phase of the 3rd stage. |
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They will watch for the signs of the placenta separating. |
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The woman's abdomen may be gently checked for any uterine changes and contractions. |
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Your caregiver may suggest natural methods for stimulating placental separation, such as latching the baby on the breast, herbs or acupressure. |
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Your caregiver may gently 'rub up' the uterus if there are signs of excessive bleeding to encourage the uterus to contract and expel the placenta more rapidly. |
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If this is unsuccessful your caregiver will administer an injection of oxytocic medication either into the woman's thigh or through the vein. |
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You may be transferred to the operating theatre if the placenta is not showing signs of separation and there is no heavy bleeding (after 60 to 90 minutes or more). A doctor may need to manually remove the placenta. |
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Once clear signs of placental separation have been noted your caregiver may ask you to squat or stand and push your placenta out or |
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They will gently apply steady tension and pressure by pulling the cord to deliver the placenta while also supporting your uterus. |
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Your caregiver will hold the placenta in their hands and gently ease out the rest of the attached membranes if they do not come readily. |
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Your caregiver may ask you to push or even cough to deliver the placenta and membranes out from your vagina and then place the placenta into a receptacle or |
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A surgical clamp may be placed on the membrane that can be seen outside the vagina, so the membrane can be twisted around the clamp to deliver them. |
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Your caregiver will examine the placenta, membranes and cord and note any abnormalities, usually in front of you explaining 'what is what' unless you request this not be done. Your caregiver will usually ask you if you wish to keep your placenta to take home for any rituals. They will dispose of it if decline to keep it. |
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If any pieces of the placenta or membranes are not accounted for it is noted on your paperwork that the placenta is 'incomplete'. Also the membranes can be noted as being 'ragged', both highlighting a 'wait and see' approach from your caregiver or staff in the postnatal ward. |