The Placenta – during birth

Skin to Skin

  • Placed on you or you bring baby to you
  • Golden Hour
  • Regulates baby’s body temperature, breathing, blood sugars, heart rate
  • Safe place so reduces stress hormones in both mummy & baby
  • If plan to breastfeed skin to skin, baby instinctively looks for food
  • Placenta is birthed – if physiological, uninterrupted birth the period between the birth of the baby and the birth of the placenta is important.  Umbilical cord contains 1/3rd of the baby’s blood volume which if they are still attached they will get it is rich oxygenated blood. (See the video in the Umbilical Cord area).
  • Increased oxytocin levels from the skin to skin helps the uterus contract
  • Placenta peels away from the uterine wall
  • Blood vessels interwoven in the muscle fibres of the uterus.  These fibres act like a ligature to stem the bleeding.
  • Physiologicalmore initial bleeding but less over the following weeks
  • Managed – ergometrine (intramuscular injection) massive contraction & expels the placenta.  Midwives may massage the top of the placenta and apply gentle traction on the cord.  Less initial bleeding but more over the following weeks.
    Higher chance of a retained placenta. Cervix closes with the placenta still inside which then results in a surgical procedure under epidural/spinal to have it removed

  • If the birth involved intervention or was particularly long or rapid or there was an issue with bleeding (normal blood loss is estimated to be around 500ml), a managed third stage would be advised.
  • Whichever third stage you choose, the cord will ideally be left to pulsate for as long as possible, and will preferably be empty. The NICE (National Institute of Clinical Excellence) Guidelines (2014) state it should not be clamped before at least one minute unless there are indications you or your baby need some help.
  • You’ll bleed for a few weeks after birth regardless of how you gave birth because the additional womb lining that made carrying a baby possible has to come out. This bleeding is known as lochia and, depending on whether you had a physiological or managed third stage, can vary in the length of time it takes for bleeding to stop. Pay close attention to any blood clots.
  • if you notice any foul smelling discharge or just feel unwell – all could be indicative of retained placenta which will need to be removed.