The Third Stage of Labor: What Happens After the Baby Is Born
The third stage of labor begins after the baby is delivered. Even though the hardest work feels complete, your body still needs to deliver the placenta. This stage is usually brief, but it is important for preventing bleeding and making sure your uterus recovers well.
How the placenta separates
Once the baby is born, the uterus keeps contracting, but the contractions are smaller and less painful. These contractions help the placenta detach from the wall of the uterus. The placenta slides away because the uterus shrinks in size, pulling the attachment loose. Small blood vessels that connected the placenta to the uterus seal off as the uterus tightens. This is how your body naturally prevents heavy bleeding.
How the placenta is delivered
After the placenta separates, you may feel a gentle urge to push again. Many women describe it as mild pressure, not pain. The placenta then slides out through the vagina. It is soft and slippery, so it usually comes out easily and quickly.
Some women choose to have a “physiological third stage,” where the placenta comes out without medication. Others choose “active management,” where a medicine called oxytocin is given right after birth to help the uterus contract. Both are safe options, and your clinician will guide you based on your health and risk factors.
What women usually feel
• Mild cramps or tightening
• A feeling of something sliding out
• Warmth or light bleeding
• Relief as the stage ends
Most women say it is far less intense than giving birth to the baby.
How long this stage lasts
For most women, the third stage lasts 5 to 15 minutes. It can be shorter for women who receive oxytocin to help the uterus contract. It may take longer if the uterus is tired or if the placenta is slow to detach.
Clinicians usually consider up to 30 minutes normal. Beyond that, they become more cautious.
What clinicians are watching for
Your team pays very close attention during this stage. They watch for:
• How much you are bleeding
• Whether the uterus is contracting well
• Any signs that the placenta has not separated
• Your pulse, blood pressure, and overall stability
• Signs of tearing or lacerations
After the placenta comes out, they examine it to make sure it is complete. A missing piece can cause heavy bleeding or infection.
How clinicians reduce bleeding
Clinicians have several tools to help prevent postpartum bleeding:
• Giving oxytocin to strengthen contractions
• Massaging the uterus through the abdomen
• Keeping the bladder empty to help the uterus tighten
• Using controlled cord traction to assist delivery of the placenta
• Treating any tears promptly
These steps help the uterus clamp down and close the blood vessels where the placenta was attached.
What “retained placenta” means
A retained placenta means the placenta or part of it does not come out on its own. This can happen if:
• The placenta does not detach
• The uterus does not contract well
• The cervix closes too soon
• A small piece of placenta remains inside
Most cases are detected quickly because clinicians are trained to recognize the signs.
When retained placenta becomes a concern
Retained placenta becomes concerning if:
• More than 30 minutes pass with no progress
• Bleeding increases
• The uterus cannot contract properly
• The placenta appears incomplete after examination
These situations increase the risk of postpartum hemorrhage, which is why attention during this stage is so important.
Treatments for retained placenta
There are several effective treatments:
Medications: Drugs like oxytocin or misoprostol help the uterus contract.
Manual removal: A clinician gently removes the placenta using a gloved hand. This is done with pain relief or anesthesia.
Curettage (D&C): Rarely, a surgical procedure is done to remove remaining fragments.
IV fluids and medications for bleeding: These stabilize the mother while the placenta is addressed.
Most women recover quickly once the placenta is completely removed.
Bottom line
The third stage of labor is usually short, calm, and uncomplicated, but it is medically important. Your clinicians monitor closely to keep bleeding under control and to ensure the placenta is delivered safely. Knowing what to expect can help you feel more confident and comfortable during these final minutes of childbirth.