The 3rd stage of labor begins after delivery of the baby and ends with delivery of the placenta. The mother can usually assist in the delivery of the placenta by pushing. If this procedure is not effective, the umbilical cord is held taut while the firm uterus is pushed upward, away from the placenta. The placenta should be examined for completeness because fragments left in the uterus can cause delayed hemorrhage or infection. If the placenta is incomplete, the uterine cavity should be explored manually.
Some obstetricians routinely explore the uterus after each delivery.
However, exploration is uncomfortable and not routinely recommended. Oxytocin should not be given as an IV bolus because cardiac arrhythmia may occur. After inspection to rule out or repair lacerations in the cervix and vagina and to be sure the uterus is contracting and after repair of the episiotomy, the mother may be taken to the recovery room, with the baby if all is well. Many mothers wish to begin breastfeeding soon after delivery, and this wish should be encouraged. Mother, baby, and father should remain together in a warm, private area for an hour or more, because this experience may increase parent-baby bonding.