Delivering the placenta
The placenta is delivered after your baby is born. This is called the third stage of labour. Your midwife should talk to you about the two options for delivering the placenta while you are pregnant and the pros and cons of each.
Your first option is called active management. This means you’ll have an injection of a drug called oxytocin into your thigh as you give birth. This makes your womb contract so the placenta comes away from the wall of your womb and you’ll usually deliver the placenta within 30 minutes. The injection can make you feel sick or vomit, but it also lowers your risk of heavy bleeding.
“I had the injection but hardly knew it was happening and can’t really remember delivering the placenta!”
Your second option is called physiological management. This means that you will deliver the placenta without any drugs, which can take up to an hour.
Your doctor or midwife will advise you to have active management to deliver the placenta, but it’s your decision.
If you choose not to have the oxytocin injection and your placenta isn’t delivered within 1 hour, or you have heavy blood loss, you’ll be advised to have the injection. You can also change your mind and have the injection at any time if you want to.
If the placenta does not deliver within 1 hour of your baby’s birth if you have physiological management or within 30 minutes of your baby’s birth if you have active management, you will be diagnosed with a retained placenta. This needs to be treated early to prevent complications. A retained placenta isn’t very common.
If you have a caesarean section, the placenta will also be delivered after your baby is born.
You can put your planned preference into your birth plan.
NICE (2014). Intrapartum care for healthy women and babies. National Institute for health and care excellence https://www.nice.org.uk/guidance/cg190
Weeks, AD. (2008) The retained placenta. Best practice and research. Clinical obstetrics & gynaeacology 2008 Dec;22(6):1103-17. doi: 10.1016/j.bpobgyn.2008.07.005. Epub 2008 Sep 14.
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