Management Options
The third stage may be managed or physiological.
Physiological third stage:
After the birth of the baby the cord is left intact and the baby is held skin to skin by the mother and preferably
breastfeeding. The normal stimulation of the nervous system and hormonal processes result in the separation of
the placenta and the contraction of the uterus. The attendant should not pull or interfere with the cord.
Physiological facilitation of the birth of the placenta is facilitated by the baby suckling, use of movement and
gravity, maternal pushing efforts with contractions, empty bladder, good hydration and watchful waiting. This
process may take up to an hour