The Third Stage of Labor
It may sound strange after the climactic moment of your baby's birth, but labor isn't over yet. The moment after your baby is born begins what's referred to as the third stage of labor, and ends with the delivery of the placenta. Though it's a relatively short stage, usually lasting less than half an hour, a lot happens in those few minutes.
More Contractions?
Your uterus may take a short break after pushing your baby out, but within a few minutes it'll begin contracting again. These contractions are meant to help your placenta, the soft organ that nourished your baby during your pregnancy, detach from the uterine wall and come out. This can take just a few minutes or up to a half hour or more.
What's Happening in Your Uterus
During this time your doctor or midwife may place a hand gently on your belly. This is called “guarding the uterus” and is the care provider's way of checking the progress of your placenta's separation from the uterus, and also “guarding” the area so that nobody else tries to massage or press on your uterus until the placenta is detached.
Alert
Nobody should massage your belly or pull on your umbilical cord until the placenta has separated from your uterine wall! If an impatient care provider tries to coax the placenta into separating before it's ready, it could cause you to bleed too much.
As your uterus shrinks and compresses the placenta, it will detach from the uterine wall. You may feel a gush of blood, some discomfort, or pressure, or you may experience a pushing urge. You and your baby can help this process along by getting him or her to nurse at your breast soon after birth. Breastfeeding releases hormones that help your uterus contract more effectively. You may not realize the placenta is ready to come out until your care provider tells you it's time to deliver it. It may seem unfair at this point, but birthing the placenta often requires some work from the mother, though sometimes it just slides out. Being upright can help, and many moms find it easiest to push the placenta out in a squatting position, though you may not be able to get upright if you have had an epidural and are still numb.
Your doctor or midwife may help you deliver the placenta with gentle traction on the umbilical cord, but nobody should ever yank or pull hard on the cord. Sometimes this part stings or burns, or it may feel uncomfortable, but the placenta is a lot smaller and squishier than your baby was — it might feel similar to a water balloon — and will come out much more easily. Your care provider will probably catch the placenta in a basin or bowl so that they can monitor the amount of blood that comes out with it.
Essential
If you've given birth underwater, as women often do at home, in birth centers, and in some hospitals, your care provider may ask you to get out of the water to birth the placenta. Some mothers also prefer to deliver the placenta on “dry land” even after they've had a water birth.
The Placenta
After the placenta is delivered, your care provider will inspect it to make sure no pieces were left behind. You may be curious to see what the organ that's kept your baby fed and provided him with oxygen inside you looks like, so don't feel shy about asking to take a look. You may even want to take the placenta home. Many families plant their baby's placenta under a tree or use it for religious or cultural rituals. As mentioned previously, some hospitals won't allow you to take your placenta home or may require that you take it home in a formaldehyde solution. Ask ahead of time to find out your hospital's policy, and come prepared by bringing an airtight container with a lid to the hospital with you. Make sure all staff involved in your baby's birth know that you want to take the placenta home, so that nobody takes it away while you aren't looking.
Fact
Animals eat their placentas, which are rich in iron and hormones and can help prevent or stop hemorrhage and possibly mitigate postpartum depression. In many human cultures, mothers traditionally ate part of the placenta.
