Third stage

• Third stage:

  • From delivery of the baby to the delivery of the placenta
  • uterus contracts - shearing of the placenta from the uterine wall
  • Indicated by sudden gush of blood and lengthening of the umbilical cord
  • 2 ways it can be managed - physiological or active management
• Physiological management:

  • No oxytocin injection given
  • Cord is clamped and cut once it has stopped pulsing
  • Woman pushes placenta out with contractions
  • Can take up to 1 hour
• Active management:

  • Aims to reduce blood loss
  • Offered to all women or initiated if there is haemorrhage or more than 60 minute delay
  • Should take no longer than 30 minutes
  • Oxytocin given to induce contraction of the uterus
  • The cord is clamped and cut between 1 and 5 minutes after the birth
  • Placenta delivered by controlled cord traction
  • After delivery the uterus is massaged until it is contracted and firm
  • Placenta examined to ensure is complete and no tissue remains in the uterus
• If the placenta has not been delivered or tissue is left in the uterus - manual removal of placenta