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How is the placenta delivered?

When you hear your little one’s first lustful scream of life, that hard work is over – baby is out of the birth canal, but labour still continues. The last and final stage of childbirth, as anti-climatic as it might be after the birth your baby, is delivering the placenta.

The placenta is commonly referred to as the afterbirth, and is generally considered by the Western world as nothing more but medical waste, but the process can be highly symbolic.

The process of delivering the placenta is rarely discussed, but should form a crucial part of your birth plan. We have discussed the difference between a natural and managed third stage of labour at length in a previous article, and your choice will determine on how you will deliver the placenta. For instance, if you wish to take the placenta home, or donate cord blood, you will have to let your doctor know in advance. Unless you stipulate otherwise, your doctor will carry out a managed third stage by default.

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What is the process to deliver the placenta?

As mentioned, the process will depend on whether or not you opted for a natural or managed third stage, and if you gave birth naturally or via a Caesarean.

Removing the placenta after a Caesarean section

The most common practise is to administer a drug called oxytocin intravenously to help the uterus to contract one last time. This contraction speeds up the process of separating the placenta from the lining of your womb. Your nurse or doctor will then gently apply cord traction by pulling on the cord through the incision your baby was delivered.

Alternatively, the placenta can also be manually removed by sweeping the placenta off the wall of your uterus. This procedure should not be routine, and is usually only applied if the placenta won’t separate and expel itself.

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Removing the placenta after a normal birth

You can choose between delivering the placenta quickly by the use of drugs, or naturally by waiting for the placenta to expel when it’s ready.

If you choose to go the natural way, it can take up to anything between twenty minutes to an hour. Massaging the uterus can speed up the process, and your doctor will encourage you to bear down into a squatting position.

Going the managed route, you will receive an oxytocin injection in your thigh as soon as your baby’s shoulder appears. A nurse will then place on her hands firmly above your pubic bone to keep the uterus in place, and tug on the cord unless the placenta comes down. It should all be over within 15 minutes.

No matter which option you chose to deliver the placenta, your doctor will check on it to ensure that it is complete and intact. If anything remains behind, it can cause a postpartum haemorrhage.

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Is it painful to deliver the placenta?

The last and final stage should not be painful as a general rule. You will experience mild to strong contractions as the placenta separates from the uterus, but believe it or not, you will hardly notice it at this stage. The placenta is roughly the size of your baby, but it is very soft and spongy, so you will feel a need that is quite similar to emptying your bowels. One final push and its all over.

Don’t be alarmed if you do feel a trickle of blood (if you feel anything at all) as the placenta separates. This is completely normal. That said, manual removal, especially during a C-section, can be quite painful and uncomfortable, but doesn’t last long. When it is all over, don’t be surprised if you feel famished and thirsty. Labour took a lot out of your body, so rest, get your strength up, and have fun with your little one.

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Source: Third stage of labour

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