The ‘third stage of labour’ is described as the time from birth of the baby to the expulsion of the placenta and membranes.
Although succinct, this description does not capture the immense beauty of a natural third stage.
Behold the exquisite moment of first contact between mother and baby in an undisturbed birth
In natural birth, the mother and baby experience peak levels of hormones that create feelings of love, pleasure and alertness during the third stage (oxytocin, endorphins and catecholamines). These natural hormones support a deep bond between the mother and baby and produces strong uterine contractions. These contractions help to separate the placenta from the uterus, expel the placenta and membranes, and control post-partum bleeding.
Observe the vivid colours of a baby transitioning to life outside the womb.
The red and purple of the blood vessels in the the umbilical cord is the transport of oxygenated blood to the baby and deoxygenated back to the placenta. In a physiological birth, the pulsating umbilical cord is left intact while the placenta continues to function. A step-wise shift in blood volume from the placenta to the baby provides an optimal level of oxygen, blood volume and full count of red blood cells, stem cells and immune cells in the baby.
In the minutes after birth, the baby makes the remarkable changes from fetal–placental circulation to independent breathing, circulation and full organ function. The change in the baby’s colour, from ‘white’/ blue/ purple to a reassuring pink, signifies a successful transition from fetal life to life outside the womb.
A natural third stage – sometimes called physiological third stage or ‘expectant’ management – is the culmination of a normal labour and birth with (little to) no intervention.
Parents choosing a natural birth, third stage and physiological cord closure should give due consideration to their chosen birth environment, the impact of interventions, the knowledge and experience of their care providers, and role of other birth attendants.
Along with undisturbed time with the baby, other factors that support a safe natural third stage for the mother include a warm, supportive environment, attention to the mother’s level of comfort, minimal lighting and distraction, delayed or no cord clamping, skin-to-skin contact and the baby initiating breastfeeding.
Thank you to Claire Teague Photography and Skye for granting permission to use this amazing photograph!
Buckley, S.J. “Leaving Well Enough Alone: Natural Perspectives on the Third Stage of Labor” , Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices (2009) New York: Celestial Arts
Mercer, J. Skovgaard, R. & Erickson-Owens, D. “Fetal to neonatal transition: first, do no harm“, Normal Childbirth: Evidence and Debate second edition (2008) edited by Downe, S. pp149-174
Mercer, J. Skovgaard R. Neonatal transitional physiology: a new paradigm. J Perinat Neonatal Nurs. 2002 Mar;15(4):56-75.