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Chapter 15 - Management of the Third Stage of Labour

Published online by Cambridge University Press:  16 October 2025

By
Anita Makins ,
Hajeb Kamali  and
Pina Amin
Edited by
Sir Sabaratnam Arulkumaran
Sir Sabaratnam Arulkumaran
Affiliation:
St George's Hospital Medical School, University of London
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Summary

The third stage of labour is defined as the time from the birth to the delivery of the placenta, which in the majority of cases is uneventful but unexpected complications can arise that can lead to significant morbidity and mortality. This chapter describes the normal physiology and how haemostasis is achieved. Expectant (physiological) and active management are described. Details of the dose and route of administration of the uterotonics are discussed. The importance of inspection of the perineum, delayed cord clamping and the correct technique for controlled cord traction is outlined. Pathological conditions such as retained placenta, its causes, management and mismanagement are discussed. The chapter concludes describing the benefits of immediate provision of postpartum long-acting reversible contraception.

Keywords

third stage of labouruterotonicscontrolled cord tractionretained placentapostpartum haemorrhagepostpartum family planning

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Chapter
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Best Practice in Labour and Delivery , pp. 184 - 194
Publisher: Cambridge University Press
Print publication year: 2025

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References

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