Management of the Third Stage of Labor

Management of the Third Stage of Labor

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Management of the Third stage of Labor


The third stage of labor refers to the period following the completed delivery of the fetus until the completed delivery of the placenta.

After the birth of the fetus, if there are no complications, the baby is laid on the mother’s chest. The baby is towel dried and the height and tonus of the fundus are checked.

Following the delivery of the fetus, the uterus decreases in size through retraction and contractions of the uterus.

The fundal height decreases from around the xiphoid to the umbilicus.

Active contractions usually start 5 to 10 minutes after the birth of the fetus. If the uterus is well contracted, the fundal height is felt at the level of the umbilicus and the uterus itself has a firm feel.

If the uterus feels soft and non-contracted and is felt above the umbilicus this may indicate an atonic uterus.

An atonic uterus may be grasped by one or two hands and balloted in order to stimulate it to contract.

As the uterus shrinks, the surface area of the placental site decreases, which causes a temporary hematoma and ultimately leads to the separation of the placenta.

There are two methods to deliver the placenta: expectant or active.

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