WHAT DOES DELIVERING THE PLACENTA INVOLVE?
Picture the muscle layers of the womb as three pieces of broad elastic. When the elastic is stretched to its maximum, this is what the womb muscle looks like at the end of the pregnancy. When the elastic is allowed slowly to recoil, it gets smaller just as the surface area of the womb gets smaller with every contraction. The placenta is solid tissue, which means that its size remains the same. When the womb contracts and the surface area shrinks, the placenta begins to separate – usually from the middle. In a slow everwidening circle, the placenta gradually loosens during the long hours of active labour. By the time the baby is ready to be born, the placenta is just about completely separated and ready to come away. When the baby suckles at the breast for the first time, this releases a hormone called oxytocin. This hormone stimulates smooth muscle to contract and not only does it initiate breastfeeding; it also helps to complete the separation of the placenta and to minimise bleeding.
Immediately after the birth, the doctor or midwife will attend to your baby while the separation of the placenta is completed. Then you may be asked to cough. While you do this, the doctor or midwife will gently pull on the cord to release the placenta. The procedure is not painful or even uncomfortable. It’s just a warm, wet feeling – like passing a very big blood clot.
The following steps should be done in order to help minimise bleeding:
Giving the mother an injection (of oxytocin) into her thigh muscle as soon as the baby’s head is delivered. This helps the womb to contract.
Initiating breastfeeding as soon after the birth as possible – this has the same effect as the oxytocin injection.
Once the womb has contracted it feels like a cricket ball just above your pubic bone. Your midwife will show you how to rub your womb to keep it contracted.
Keep your bladder empty. Even though it may be difficult to pass urine, a full bladder can interfere with afterbirth contractions.
Once the placenta is delivered it will be examined by the doctor or midwife to make sure that no pieces have been left behind, and that the membranes (bag of waters that your baby grew in) are also complete. The placenta is incinerated at the hospital, but for home births, arrangements can be made for its burial. Often a memorial tree is planted with the placenta to celebrate a new life.
CAN YOU HOLD YOUR BABY DURING THIS TIME?
Providing there are no complications, holding your baby skin to skin (holding your baby directly on your chest) immediately after the birth is particularly helpful – even if you have had a c-section. This early bonding not only reunites the baby with his mother, it brings them both comfort and intimacy after what may have been long and tiring hours of labour.