The Third Stage of Labor: Placenta Delivery & Risk for Hemorrhage

Whether you are expecting your first baby or about to experience a repeat birthing experience, it is important to understand that not all labor, delivery and birthing experiences are the same. For many women, the birthing process is natural and flows without complications.

For some women, however, there are complications of the birthing process. One such complication, known as the post partum hemorrhage is a health complication that occurs during the third stage of labor and delivery.

The third stage of labor and delivery encompasses the time following the birth of your infant until the time the placenta is delivered. To manage this stage correctly, your obstetrician will cut the umbilical cord, stopping pulsation, separate the placenta from the uterus and then delivery the placenta. During this process, when delivery of the placenta is not achieved quickly, there is risk for extensive blood loss also known as hemorrhaging.

In most deliveries, the process of umbilical separation, separation from the uterus and delivery of the placenta can occur with little assistance from the physician. However, when complications of pregnancy occur, the obstetrician may need to offer assistance in moving this process along, known as active management.

In active management of the third stage of labor, your obstetrician may opt to take a slightly passive approach by administering an IV drug to you immediately after the birth of your infant. This IV drug, known as an uterotonic will aid the uterine contractions to pulsate the placenta away from the uterine wall. While this IV drug is administered during labor, the obstetrician may clamp the umbilical cord to stop the pulsating and then use a controlled tugging motion on the umbilical cord to aid in the delivery of the placenta. In following this practice, there is a reduced risk for hemorrhaging during this third stage of labor.

If you are expecting a baby, it is important to discuss all aspects of prenatal care with your healthcare provider. As part of your discussions, inquire about the labor, delivery and birthing techniques that will be used, including those to not only manage pain but also to manage any potential risks that may arise during this third stage of labor and delivery. With active management by your physician, using medications, clamping of the umbilical cord and delivery of the placenta, your third stage of labor can be shortened leading to a decreased risk for post partum hemorrhaging.