The movie montage of giving birth goes a little something like this: Contractions start. Water breaks. Pain and suffering. Rush to the hospital. Scream, “You did this to me!” at partner. Sweaty, guttural pushing. Baby emerges and is placed on your chest. Everyone smiles.
The truth is, when you deliver your baby, you’ve completed just two of the three stages of labor. Assuming all is well health-wise, baby’s on your chest and you’re on to stage 3, usually the shortest of all: delivering your placenta.
The third stage can take anywhere from 5 to 60 minutes. The oxytocin produced by all those newborn snuggles, cuddles, and kisses causes your uterus to continue contracting, expelling the placenta that nourished your baby for the last 40ish weeks. Sometimes, in a medically managed third stage, your obstetrician or midwife might utilize Pitocin to stimulate these contractions. Your midwife or obstetrician might ask you to give a little push or they might hold some traction on the umbilical cord. The placenta slithers out, which usually feels a bit strange, but not painful as placentas are soft and malleable.
An issue that may arise during the third stage is retained placenta, which means all or a piece of the placenta remains attached to the uterine wall. This can cause excess bleeding. If the placenta cannot be removed, a surgeon will go in for a manual extraction of the placenta.
Once your placenta is delivered, your OB, midwife, or nurses will continue to keep an eye on your postpartum bleeding and massage your uterus (which doesn’t feel quite as lovely as it sounds!) so it continues to contract and shrink.