Your Pregnancy - - Month By Month -

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.


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.

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