Labour - stage three

The third stage of labour is the delivery of the placenta (the afterbirth) and the membranes. It begins just a few minutes after your baby's birth, and lasts between 10 and 20 minutes.

You might hardly be aware of the third stage happening.

Usually, you're given an injection of hormone into your thigh or your buttock, which stimulates the uterus to contract. This injection is given when your baby's being born, usually when the first shoulder is emerging. The midwife should ask you for your consent before she does it.

Then, as your baby is born, the umbilical cord is clamped, and cut.

The injection now takes effect. The uterus contracts very strongly, and the placenta peels itself off the inner wall of the uterus. You may be able to push the placenta out, or else the midwife helps the delivery of the placenta by putting one hand on the abdomen to protect the uterus, while the cord is kept taut with the other.

At the same time as the placenta peels away, the blood vessels, which hung on to it close off, and stop bleeding (though it's normal to bleed a little).

A physiological third stage - using no injections, and waiting to cut the cord, and without helping the delivery of the placenta - means leaving things to happen naturally.

The action of feeding your baby at the breast, or just simply having the baby there, stimulates the release of the hormone oxytocin. This acts on your uterus, which then contracts, expelling the placenta and membranes. The cord is cut when it stops pulsating, and often after the placenta is delivered.

If you prefer a natural third stage, tell the people looking after you, and discuss it before you go into labour. If you have had problems during your pregnancy, or during your labour, a natural third stage may not be a safe option.