Labor Stage 3: Placenta Delivery

00:01 Now let's discuss the third stage of labor.

00:05 So let's review our stages of labor.

00:07 Stage 1 is the onset of labor until 10 centimeters dilated.

00:11 Stage 2 is 10 centimeters dilated until delivery of the infant.

00:15 And then stage 3, starts with the delivery of the infant and ends with the delivery of the placenta.

00:22 Now here's a clinical pearl.

00:23 There are three signs to let you know the placenta is ready to deliver.

00:27 First is lengthening of the umbilical cord.

00:30 As you start to apply your gentle traction as the placenta separates, the cord will lengthen.

00:36 Next, there's a gush of blood again from the placenta separating from the uterus.

00:41 And then the uterus becomes more globular as the placenta separates and it's no longer at the fundus, the uterus becomes more globular.

00:50 So what's the process for delivery of the placenta.

00:53 We apply gentle downward traction with counter traction on the uterus.

00:57 That counter traction is very important.

00:59 Failure to do so can result in uterine inversion.

01:02 where the uterus turns inside outside and that's a surgical emergency.

01:07 Sometimes there can be delays in the delivery of the placenta.

01:09 And that most common way is related to an abnormal placentation.

01:13 So that's going to be our placenta acreta, increta or percreta.