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BIRTHING YOUR PLACENTA

WHAT IS THE THIRD STAGE?

The third stage is the birth of the placenta, which takes place shortly after your baby is born. During the birth of the placenta you will experience uterine contractions as the placenta separates from the uterus wall, moves through the cervix and, when it has moved down far enough, you will work with a final contraction to push and get the placenta the rest of the way out.

As the third stage often gets little mention in pregnancy books, lets discuss how protecting the third stage environment, as we do with our birthing environment, may encourage a faster, natural delivery of the placenta, reducing the need for intervention or an ‘actively managed’ third stage.

For the new mother, the third stage is a time of reaping the rewards of her labour

Dr Sarah Buckley, Gentle Birth Gentle Mothering

THE PLACENTA

(noun) A flattened circular organ in the uterus of pregnant eutherian mammals, nourishing and maintaining the foetus through the umbilical cord.

When you become pregnant, your uterus contains just a cluster of cells. Half of those go on to become your baby and the other half become the placenta. The placenta is a temporary organ that is attached to the wall of the uterus during pregnancy. It performs many functions including providing nutrients, oxygen and protection against harmful bacteria via the umbilical cord. More or less anything you consume will pass to your baby via the placenta.

The placenta also disposes of the baby’s waste, such as carbon dioxide, which passes back up the umbilical cord to your blood stream where your body disposes of it.

Put simply, the placenta serves as the baby’s lifeline during the 40ish weeks in the womb and should be recognised for it’s vital role!

THIRD STAGE PHYSIOLOGY

In many hospitals now, it is routine to have an actively managed third stage. Which means, as your baby is born, you’ll be given an intramuscular injection of syntrometrine – a synthetic form of oxytocin. Some women may not have a preference whether or not they have an actively managed or a physiological (natural) third stage (see below for pros and cons) but for those that do, its good to know what things could help the third stage progress so that you are able to protect the ‘golden hour’ and deliver the placenta naturally.

As mentioned above, oxytocin continues to play a huge role during the third stage. Oxytocin is a very shy hormone and there are things within the environment that can cause adrenaline to spike and for oxytocin levels to decrease, which will slow uterine contractions. In order to keep a good hormonal balance it is important to continue to protect the birthing space.

BREASTFEEDING AND SKIN-TO-SKIN

Initialising that first feed encourages the release of oxytocin, but if your baby doesn’t show signs of wanting to breastfeed straight away, just holding her close to your chest will have a similar effect.

MOTHERS COMFORT

Maintaining the environment of the birth space with low lights, warmth and no observers encourages the mother to feel comfortable and, in turn, speeds up the duration of a natural third stage.

Stimulation of the breasts causes a powerful endocrine hormone called oxytocin to be released. Oxytocin in turn stimulates uterine contractions.

Ina May Gaskin, Spiritual Midwifery

A PHYSIOLOGICAL THIRD STAGE:

  • Encourages a calm, quiet and undisturbed atmosphere allowing you to be present with your new baby.
  • Allows time for bonding through breastfeeding and skin-to-skin.
  • You can adopt different positions and move instinctively with your body.
  • Physiological management is less likely if labour has been induced or required pain management/intervention, as the administration of synthetic oxytocin will inhibit your ability to produce your own oxytocin.
  • Sometimes placentas can take longer to be born (anywhere between 1-12 hours!). This is not an indication the third stage needs to be actively managed. A gentle, hands-off approach is key here, as long as blood loss is monitored. It is worth noting, you are less likely to be given an extended amount of time to birth your placenta in a hospital setting.
  • For more information on why it is so important to have a hands-off third stage, check out this article by Sarah J. Buckley.

ACTIVELY MANAGED THIRD STAGE:

  • Is a quicker process than a physiological third stage, lasting 5-15 minutes. After synthetic oxytocin is administered the placenta needs to be delivered quickly to avoid retained placenta.
  • In the event of the placenta taking a long time to be born, it will have to be removed manually under general anaesthetic.
  • You may experience discomfort when the midwife performs the controlled cord traction (CCT), after you receive synthetic oxytocin via an intramuscular injection. A CCT involves the midwife placing her hand on your abdomen so that she can feel when the uterus contacts. She will then pull gently on the cord whilst applying pressure to the uterus.

OPTIMAL CORD CLAMPING

Another thing very injurious to the child is the tying and the cutting of the navel string too soon; which should always be left till the child has not only repeatedly breathed but till all pulsation in the cord ceases. As otherwise the child is much weaker than it ought to be, a portion of the blood being left in the placenta which ought to have been in the child.

Darwin, 1801

For many years immediate clamping of the umbilical cord (between 10-15 seconds) after birth has been standard practice. There is now extensive evidence to suggest that it is beneficial to allow the cord to fully pulsate, or better yet ‘wait for white’, before clamping for the following reasons:

  • The cord and placenta hold up to 30% of your baby’s blood. Allowing the cord to pulsate means the blood can flow through it and aid the baby’s lung expansion. When the cord is clamped immediately, blood has to be “borrowed” from the rest of the baby’s circulation in order for the lungs to fully function.
  • As the baby receives the full amount of blood from the placenta, iron levels are higher and it reduces the chances of anaemia. Anaemia in infants can go on to effect the development of the nervous system and brain development.
  • Delaying the clamping of the cord allows the baby to receive up to a billion more stem cells than if it were clamped immediately after birth. Stem cells have wonderful healing qualities.
  • Increased birth weight and blood pressure stabilised.
  • If resuscitation is required after the baby is born, it is beneficial to leave the cord unclamped as it assists in oxygenating the lungs.
  • The cord stump will often take less time to heal and ‘drop off’ after delayed cord clamping.

CORD BURNING

Some people choose to burn the cord a few hours after birth. This can be a gentle and respectful way to sever the cord and break the connection between baby and placenta. It is also likely the cord stump with dry up and fall off quicker if it is burned.

For more information on cord burning ceremonies, tap here.
It’s worth noting, this option may not be supported within a medical setting.

LOTUS BIRTH

“Lotus birth is the practice of leaving the umbilical cord uncut, so that the baby remains attached to his/her placenta until the cord naturally separates at the umbilicus – exactly as a cut cord does – at 3 to 10 days after birth. This prolonged contact can be seen as a time of transition, allowing the baby to slowly and gently let go of his/her attachment to the mother’s body.”
– Sarah J.Buckley, Placenta The forgotten Chakra.

For more information on lotus birth, tap here.

MAKING A THIRD STAGE PLAN

It can be very beneficial to include your wishes for the third stage in your birth plan. You have the right to an empowered third stage too. Things to consider for a physiological third stage:

  • State that you’d like to try for a natural placenta birth. Create an optimal environment for birth – warm, dim lighting, quiet, private, supported.
  • Do not allow a hat to be put on your baby’s head. This puts a barrier in the way of you being able to smell your baby, which is vital in stimulating oxytocin.
  • Allow time for the cord to go completely white before clamping. This is a sign that all the blood has been drained from the placenta.
  • Immediate skin-to-skin with your new baby.
  • Put your baby to your breast. Try to initiate the first feed. Keep things calm and undisturbed.
  • State if you want to wait for newborn checks and weighing.
  • Don’t be afraid to ask to see the placenta once it has been delivered. If you want to take it home to benefit from placenta remedies ensure you state this in your birth plan and have your birth partner discuss plans with your midwife upon arrival.

BENEFITTING FROM YOUR PLACENTA

The placenta is becoming increasingly recognised for the important role it plays in post-birth healing. According to the Placenta Remedies Network “during and after a normal vaginal delivery (including post-natal bleeding) a new mother will lose between 1/8 to 1/10 of her body’s blood supply. Losing a large amount of iron so quickly can cause anaemia, leaving a new mum feeling tired, faint and exhausted. The blood needs high supplies of iron to carry oxygen to the cells. Low supplies of oxygen leave your cells starving and less able to heal after trauma.”

Consuming your placenta, which is rich in vital hormones and minerals, restores your iron levels reducing fatigue. Blood loss during the postnatal period can last for 3-6 weeks. Consuming your placenta can reduce postpartum blood loss to 5-10 days because the placenta is full of stem cells and growth factors, which play a huge role in healing the wound in your uterus. Your placenta also aids the replenishment of vitamins E and B6, is rich in hormones such as oxytocin and corticotropin and immune boosting proteins. In addition to reducing the duration of postpartum blood loss, all of the wonderful nutrients in your placenta contribute to encouraging a plentiful milk supply, boosting energy levels and balancing hormone levels reducing the chances of “baby blues” and postnatal depression.

Your placenta can be made into numerous different remedies, including:

  • Raw placenta smoothie
  • Placenta Encapsulation
  • Tincture
  • Essence
  • Homeopathic Remedies
  • Creams or balms

There is growing interest both in the placenta as an extraordinary organ which nourishes the baby during pregnancy, and the rituals surrounding it in other cultures.

AIMS, Birthing Your Placenta

Did you find this useful? Please use the comments section below to share your placenta stories!