Just when you think it’s all over and you’re ready to snuggle up with your new baby, the contractions start again and it’s time to deliver the placenta. But what does this actually mean for your body? Also known as the ‘third stage of labour’, there are potentially important decisions to be made here that are worth considering in advance.
Delivering your placenta
A physiological third stage of labour essentially means you wait for the placenta to be delivered naturally, as opposed to a managed delivery where a drug, oxytocin, is given to stimulate delivery. Often a managed third stage is advocated in hospitals and will happen by default, because it can reduce the risk of serious bleeding post-delivery, and it speeds up the process as the placenta can take up to an hour to deliver naturally. A managed delivery is the method recommended by the World Health Organisation (WHO) and International Confederation of Midwives due to the reduced risk of post-partum haemorrhage.
However in healthy deliveries, birthing the placenta naturally allows plenty of natural bonding time between mum and baby, which in turn, eases the third stage along, and NICE (The National Institute for Health and Care Excellence) recommends that women at low risk of postpartum haemorrhage who request a physiological delivery be supported in their choice.
Dr Sarah Buckley, a leading natural birth expert and author of ‘Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices’, explains why you might want a physiological third stage: “Medical management of the third stage […] has its own risks for mother and baby [...] Drugs used in active management have documented risks for the mother and we do not know the long-term effects of these drugs, which are given at a critical stage of brain development, for the baby.” You have the ability to choose which way you would like to delivery your placenta, whether naturally or with medical assistance, and this is something you can write on your birth plan.
Delayed cord clamping
Another aspect to consider during the third stage is whether delayed cord clamping is important to you. According to the WHO, late cord clamping (one to three minutes after delivery or longer) is recommended for all births and many midwives advise women to wait until the cord stops pumping blood. Delaying cord clamping allows more blood to transfer from the placenta to baby, sometimes increasing blood volume by up to a third, while the iron in the blood increases an infant’s iron storage. But don’t take it for granted that all hospitals will automatically offer this, instead make sure your request is clear on your birth plan.
Stem cell collection
Whether you want to opt for stem cell collection is another consideration at this stage, with many medical opinions still divided on the practice. Cord blood found in the placenta and umbilical cord after birth is rich in stem cells, which can be used to treat all manner of diseases and disorders in your child’s later life. The process sees the cells harvested and stored in case needed, however, it’s an expensive option that usually involves cutting the cord early, depriving baby of that first blood supply. It is also a measure that (hopefully) may never be needed.
What to do with the placenta
Finally, it’s worth thinking about what you want to do with your placenta after birth. No longer a celebrity fad, more and more mums are taking the plunge and having pills made from their placentas, believing the health benefits can range from easing the baby blues to boosting milk supply. However, despite being an ancient practice, there are few scientific studies to back up any positive side effects of popping placenta pills, other than the glowing reviews of mamas who’ve gone for it. You must make it clear if you wish to keep your placenta after birth, as otherwise the hospital will discard it as a matter of course.
Read more: Why you might want to eat your placenta