Onto stage 3.
In stage 3, the baby is out.
We've done that and everybody is 'oohing
and ahhing' about the baby and that's wonderful.
But there's still work to do.
So delivery of the placenta
is what makes up stage 3.
This can last up to about 30 minutes.
And we want to think about the
fact that the placenta has to come out,
because if it doesn't, then
we're going to have bleeding.
So it's a wonderful thing, it's a
beautiful thing, it has to happen
and there are things that we must
monitor to make sure that it goes well.
How are we going to know
the placenta cut is coming out?
There are a few signs, one
is lengthening of the cord.
The placenta is actually going to
drop away from the uterine wall.
And so the the umbilical cord,
that's sort of hanging on the outside
is actually going to get longer.
We're going to see it because
the placenta is going to move.
And then we're going to see a gush
of blood from behind the placenta
as it detaches from the uterine wall.
And then all of this happens
because the uterus is contracting, right?
And so as it contracts, it actually lifts
up, and the provider can feel it.
So if you're palpating someone's
abdomen, you can feel the uterus
sort of make a tennis ball sort of feel to it.
And that lets you know, when
those three things happen,
that the placenta is ready to be delivered.
And we can apply gentle traction and
actually evacuate the placenta from the uterus.
Pretty cool, all right.
What is the nurse doing during third stage?
They're monitoring transition of the newborn.
So while everybody is oohing
and ahhing about the baby,
we want to make sure the
baby is transitioning okay.
We also want to be aware
of any potential complication,
So is third stage taking
too long? Is there bleeding?
Is the uterus not contracting? What's
going on, is the mom doing okay?
Vital signs, are they stable? Is the baby
stable, because if anything is happening
that we need to intervene, the nurse
has to really be aware in order to make sure
things happen the way they should.
All right, that's a lot.
So let's review, I have some questions.
I'm going to ask and then take a pause and
let's see if you can come up with the answer.
We have a nurse who is caring for
a patient who has recently delivered,
which of the following indicates
that the third stage of labor is ending?
There is a gush of blood from
the vagina, alright, very good!
This lets us know that the
placenta is ready to deliver because
that is what happens in third stage.