STAGES OF LABOUR

| Feelings | What does the doctor do | Do's and Don'ts |

Once the baby is delivered, the uterus contracts and shrinks in size. Due to this the placenta separates from the inner surface of the uterus and is expelled out.  The period after delivery of the baby to delivery of the afterbirth is called 3^rd stage of labour.
This usually lasts for more than 30 minutes. If it lasts for more than 30 minutes, surgical intervention may be needed to remove the placenta. Surgical intervention may also be needed in case of excessive bleeding during this stage.
Major part of the delivery is over. You have done your job in delivering the baby. All that remains of labour is the “finishing touch”.

What do you feel?

• After the delivery of the baby you may feel exhausted. But the exhaustion will be overridden by the sense of elation on looking at the bundle of joy, which the past 9 months had been within you.

• The placenta is still within the uterus and the uterus tries to expel it. Hence you will feel the contractions, but they are in no comparison to the ones felt during the earlier stages.

• There may be some amount of bleeding during and after separation of the placenta.

• Your perineum may feel some pain because of the stretching and episiotomy ( if the effect of local anaesthetic is wearing off).

What does the doctor do?

• The doctor / nurse may give you some injection (intravenously or in the buttocks) for hastening the separation of the placenta.

• Some doctors wait for spontaneous expulsion, while others give controlled traction on the cord and hasten the delivery of the placenta.

• Once the placenta is delivered, it is checked for its completeness and to rule out any piece being left behind.

• Once the placenta is checked, your vagina may be cleaned of blood clots and a vigorous rub given to your uterus by an internal as well as abdominal massage. This is done to make the uterus contract well and prevent excessive bleeding.

• The episiotomy       is then stitched (if required more local anaesthetic may be injected).

• The vagina and perineum is then checked for bleeding and then cleaned with soap and antiseptic and a perineal pad is placed in position.

• Your general examination, pulse rate, blood pressure may be then recorded.

• Subsequently you may be asked to rest in the labour ward for some more time. 

Your Role – Do’s and Don’ts

During the 3^rd stage your active participation is reduced to just pushing once or twice when the doctor asks you to. This helps in expelling the placenta.
What is expected from you is co-operation. Some do’s and don’ts are as follows:

Next