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Stages and Phases of Labor: Stage 3

calendarJuly 26, 2016
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Placental expulsion

After the delivery of the baby, the third phase of labor is yet to come. After the first stage of labor – the early labor and the active labor which is the second stage of labor, the transition phase is the last one. This is the time of the placenta delivery. As soon as you deliver your baby, the uterine contractions will stop. The labor pains will disappear and you will feel relieved and totally exhausted at the same time.

What Happens to the Placenta after Birth?

When the placenta separates, the woman will once again start to feel painful uterine cramps. As the moment of the descending of the placenta after birth through the birth canal, pregnant women feel the urge to push it out. If the delivery of the placenta fails for some reason, it should be removed manually by a health specialist. After the placenta has been delivered, a firm contraction of the uterus usually closes the open blood vessels which supplied the placenta during pregnancy and labor. If there is no such contraction, this might lead to rapid blood loss.

Ways of Delivering the Placenta

You can choose to deliver the placenta naturally or with medical intervention. The doctor will offer you an injection to help you deliver the placenta quickly straight after your baby was born. This will reduce the risk of losing too much blood. The drug, used for this purpose is usually oxytocin. Occasionally, syntometrine might also be used. These chemicals help the contraction of your womb. Thus, all of the blood vessels in the wall of the womb seal off when the placenta comes away. This intervention is usually called "active management of the third stage of labour".

Since it speeds up the delivery of the placenta after birth significantly, this delivery will probably last between five to ten minutes. There is nothing to worry about the injection because it might only have slight side effects of making you feel dizzy or sick. This is less common with oxytocin in comparison with syntometrine. Also, having an injection after giving birth is not scary at all having in mind what you have been through.

Also, having an injection after giving birth is not scary at all having in mind what you have been through. The usual way to encourage the uterus to firmly contract is to give the mother oxytocin 10 mIU IM. The other option is to use oxytocin 10 or 20 units in a liter of intravenous fluids.

The Natural Way

You might choose not to have the injection and let the placenta be delivered without any medical intervention. This is a natural way and it can take up to an hour. If you choose this way, be prepared to have a heavier blood loss which might also cause you dizziness. When you breastfeed your baby or have nipple stimulation, your pituitary gland will release oxytocin internally. This will cause similar, but usually slighter effects in comparison with the injection.

Take the Right Decision

Medical specialists will advise you to have an injection of oxytocin if you have gone through a very long labor. You have already lost too much energy and this is the way to make it easier for you. Consult with your doctor what you should do according to your condition after giving birth.

What Does a Placenta Look Like?

During pregnancy the placenta changes its size and shape. You will be able to see it when the placenta is coming down but you will probably be too exhausted to pay too much attention to it.

What is the Afterbirth?

After the cord is clamped and cut, the baby should be dried. This will prevent the child from getting cold. Now you will be allowed to finally hold and cuddle the baby. He or she might still need to be cleaned a few more times as it will probably have some of your blood and the vernix on their skin. If you worry that your baby is covered with these substances, you could ask the midwife to wipe the little child and then wrap her or him in a blanket. 

Sometimes, there is mucus in your baby’s nose and mouth and it has to be cleaned. If the baby has problems breathing, then the child has to be taken to a special area of the room where to be given oxygen. Do not worry - the baby will not be kept away from you any longer than it is really necessary.

Time to Cuddle

Placenta delivery

Your baby will need and enjoy being close to mom after the birth. Cuddling will help you build a connection between each other. This is also the time when the baby will start to get to know this new world. The best way to do this is in the arms of mom. The doctor or the midwife will examine the baby to check whether everything is normal. The baby will then be weighed and measured.

Avoiding Haemorrhagic Disease of the Newborn

The medical specialists will offer the mother an injection of vitamin K for the baby. This is considered to be the most effective way of preventing a rare bleeding disorder, called a haemorrhagic disease. This is something that you would better discuss with your midwife or doctor before the delivery of the baby. Oral doses of vitamin K are also available, if you do not want your baby to have an injection. However, further doses of the vitamin will be necessary, if you choose the oral form.

What Does Afterbirth Look Like?

After the placental expulsion, you will only want to have rest and to cuddle your baby. More tasks, however, need to be completed. If you have big wounds after giving birth, you will need stitches. The midwife or a nurse will help you wash. This will make you feel better and will prevent infections. Then you will either go home or to the postnatal area. This depends both on your choice and your condition.

Preventing Bleeding

Not only could the baby have haemorrhage. The postpartum haemorrhage (PPH) is a rare but serious and dangerous complication. In these cases the woman bleeds heavily from the vagina after the baby was born. She might have a serious blood loss in a short period and this condition requires the adequate reaction of the medical stuff.

Types of Postpartum Haemorrhage

There are two types and they differ from each other, depending on when the bleeding takes place.

  1. The first type is called primary or immediate. In these cases, the bleeding appears within 24 hours of giving birth and usually doctors expect it and react quickly.
  2. The secondary or delayed haemorrhage includes bleeding that occurs after the first 24 hours. It might even appear up to six weeks after giving birth. Call your doctor immediately if you notice vaginal bleeding days or weeks after delivery.

Causes of Haemorrhage

This dangerous condition might be caused by one of the following factors:

  • uterine atony;
  • a part of the placenta has left inside you;
  • an infection of the membrane lining the womb. This condition is called endometritis.

The Baby after Birth

What is after birth

In the first hours the baby quickly has to get to know this new world. During these hours the baby is recommended to be held skin to skin. Then, there are nine observable newborn stages which are innate and instinctive for the baby.

1. Crying This is usually the way the baby appears in our world. This is what he or she will do immediately after birth as the baby’s lungs expand. If there is no crying, this is a very disturbing sign and the doctor should react quickly since there might be a problem with the breathing of the child.

2. Relaxing This is the moment when the baby is totally relaxed. This usually happens after the baby crying has stopped completely. He or she is more probably to relax when it is skin to skin with the mother and he or she feels warm, covered with a dry towel or blanket.

3. Awakening The awakening is combined with slight movements of the head and shoulders. You could expect this to happen about 3 minutes after birth.

4. More Activity Now the baby will begin to make increased mouthing and sucking movements. The stage of moving usually begins about 8 minutes after the baby was born.

5. Rest In these first hours the baby will regularly alternate the stages of having rest and activity.

6. Slight Crawling Through crawling the baby will approach the breast and nipple. You might expect this to happen about 35 minutes after you have given birth.

7. Familiarization with Mom Licking the nipple, touching and massaging the breast of mom is the baby’s way to familiarize with her. The familiarization process usually starts around 45 minutes after the baby was born and this could last more than 20 minutes.

8. Suckling This is the time for having a meal. The newborn will take the nipple and will start suckling about an hour after birth.

9. Having Some Sleep After the whole adventure, both the mother and the baby need to sleep. The baby will probably fall asleep 1.5 to 2 hours after the delivery.

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