Labour - 3rd Stage
 So far we have covered the First Stage of Labour and the Second Stage of Labour. Now for the last or third stage... All that remains now within the uterus is the placenta, the attached cord and the remnants of the pregnancy sac. Although you may not feel it, the uterus continues to contract causing the placenta to peel off from the uterine wall.
A naturally occurring hormone called oxytocin is produced within the body to help this process. The squeezing of the uterine wall closes off the supply to the blood vessels, preventing excessive bleeding from the wall and keeping blood loss at a minimum.
When the placenta is detached, the doctor or midwife may gently pull on the cord and you may be asked to take a breath and bear down to assist.
After it slides out, it will be closely examined by the person who delivered the baby to check that every part is there. This is to avoid any section being left within the womb, which if left unnoticed, could cause infection during postpartum.
Oxytocin Injection
Often during a hospital birth, it is a common practice to inject oxytocin into a muscle or drip as soon as the baby is born to induce the delivery of the placenta. The potential for haemorrhage immediately after childbirth is at its greatest and this usually increases with successive pregnancies.
In the nineteenth century, excessive bleeding at this stage was a common cause of women dying in childbirth.
Today’s routine administration of an oxytocin injection at birth has meant that far fewer women suffer from postpartum haemorrhage and if they do, it is likely to be less severe, often without need for a blood transfusion.
The progressing dilation of the cervix during the stages of labour
The progressing dilation of the cervix during the stages of labour.
The Placenta
The placenta will look like a piece of raw liver with a rough side, that which was attached to the uterine wall, and a velvety smooth soft side, against which the baby was cushioned.
It will have an intricate network of blood vessels which during pregnancy, was the baby’s life support system supplying oxygen and nutrients.
The significance of the placenta in its role of creating and sustaining life has long been recognised by tribal cultures. Some choose to mark its importance with a burial in a sacred place, creating what is considered to be a “place to come home to”.
Cutting the Cord
Once the baby breathes air, it has not further need for the placenta or the umbilical cord. Within a few minutes of the birth, once the cord has stopped pulsating, the cord can be clamped with forceps.
Clamps are usually placed at two points, and with a pair of sharp, sterile scissors, the cut is made between these points.
A clamp is then moved closer to the umbilicus (tummy button) so the excess cord can be trimmed.
There is no hurry for this to be done and there may be some advantages for the baby in waiting for the blood within the cord to drain into its circulation.
Cord Blood Collection
The blood within the umbilical cord is considered to be rich in special blood cells called “stem cells” also found in bone marrow.
Stem cells can be used to successfully treat children with leukaemia (cancer of the blood cells).
For this reason, in some countries you may be asked if you would care to donate to a cord blood bank.
The collection has to be planned beforehand so that the cord can be cut quickly and the blood collected into a special container by a trainer technician so it can be immediately frozen. The collection process is painless and harmless for both the mother and newborn.
If you are asked to donate to the cord blood bank, consider the request carefully.
Repairs to the Perineum
Should your perineum require stitches, suturing is done under local anaesthetic and can often take a long time as careful precision is taken in joining together the underlying layers of muscle.
An icepack can help reduce swelling. The bloodstained vaginal discharge common following childbirth is called lochia. Some women experience it for just a few days though for others, it may last as long as five or six weeks.
This article is courtesy of Nine Months your online guide to pregnancy, birth and life. |