Helping the placenta to come

The woman's body is usually capable of expelling the placenta unaided, but there may be some circumstances when the woman and the caregiver need to help the placenta to be fully expelled, while still facilitating a physiological 3rd stage and being careful not to interfere with the natural process.

Circumstances that may require help can include:

• The placenta not separating
• Breaking the cord - if the caregiver is performing a controlled cord tractions to deliver the placenta the cord can break or snap. This is more of a nuisance than a problem.
• The placenta being held in the cervix - once the baby is born the cervix closes down to a certain degree, but remains partially open to allow the placenta to be born. Occasionally the placenta can be 'held up' in the opening of the soft cervix and may require some gentle assistance to be completely expelled.
• The membranes being held in the cervix - The membranes are attached to the placenta, but are like delicate sheets of tissue that are expelled behind it. Occasionally the friable membranes (or sac) will remain held in the cervix, being possible for the membranes to tear and / or be partially left inside the uterus, if not eased out gently.

If the membrane is retained it will normally come away on its own in the first couple of days after the birth, but occasionally it can cause heavier bleeding or possibly an infection in the uterus if not eventually expelled.

Find more:

• Bonding with your baby
• First bottle feed
• First breastfeed
• The 1st hour with your newborn
• The next 23 hours with your newborn