Firstly, the management of third stage of labour (MTSL) is the crucial phase during Labour. Bringing a new life into the world is one of the most incredible & transformative experiences in a woman’s life. The entire process of childbirth is complex, & it consists of three stages. While most people are aware of Normal Labour Stages & the first two stages of labour. However, the third stage of labour often goes unnoticed. But it is a crucial phase that marks the completion of the birthing process.

In this article, we’ll explore the management of the third stage of labour & its significance in the childbirth process. Additionally, we’ll look at what happens during the third stage of Labour, the importance of the third stage of delivery, & why it is essential for both the mother & baby’s health.

In this section we will discuss preparation for the 3rd stage of Labour:


Preparing for the Third Stage of Labour

The third stage of Labour is the final stage of childbirth when the placenta is delivered after the baby. While this stage may seem like an afterthought, it is an important part of the birthing process that requires preparation & attention. Here are some steps to take to prepare for the 3rd stage of Labour, as well as some common challenges that can occur:

Discuss Your Options with Your Healthcare Provider

 Moreover, before the delivery, talk to your healthcare provider about your options for delivering the placenta. There are two main methods: active management & physiological management. 

  1. Active management of the third stage of labour involves giving medication to help the uterus contract & push out the placenta quickly.
  2. Physiological management involves allowing the placenta to deliver naturally without medication. Your healthcare provider can discuss the benefits & risks of each method & help you decide which is best for you.

Learn About the Signs of Placental Delivery

 It’s important to know what to expect during the third stage of Labour so you can recognize when the placenta is ready to be delivered. Signs include a feeling of fullness or pressure in the vagina, a gush of blood, or a sudden decrease in the size of your uterus.

Furthermore, the placenta is an organ that develops during pregnancy & connects the developing fetus to the uterine wall to allow for the exchange of nutrients, oxygen, & waste products.

Stay Hydrated

Additionally, staying hydrated during labour can help prevent complications during the third stage of delivery. Make sure to drink plenty of water & other fluids throughout your labour.

In this section we will discuss medical management of 3rd stage of labour :

Medical Management of the Third Stage 

Medical management of 3rd stage of labour (MTSL) refers to the use of interventions & medications to facilitate the safe delivery of the placenta & prevent complications. Lastly, here are some common medical techniques used during the third stage of delivery:

Active Management of Third Stage

Active management of the third stage of Labour involves the administration of a uterotonic drug, such as oxytocin, within one minute of the delivery of the baby’s shoulders. The drug causes the uterus to contract, which helps to detach the placenta & reduce bleeding. Assist in the delivery of the placenta by applying gentle traction to the umbilical cord. This technique significantly reduces the risk of postpartum hemorrhage, indicating its effectiveness.

Delayed Cord Clamping

Delayed cord clamping involves waiting to clamp the umbilical cord until after it stops pulsing or for a certain amount of time after delivery (usually 30-60 seconds). This allows more blood to transfer from the placenta to the baby, which can improve iron stores & red blood cell counts in the infant.

Controlled Cord Traction

Controlled cord traction involves applying gentle traction to the umbilical cord to help deliver the placenta. Healthcare providers typically use this technique alongside uterotonic medication.

Manual Removal of Placenta

In some cases, the placenta may not deliver spontaneously or may be partially retained. In these cases, manual removal of the placenta may be necessary. This procedure involves manually detaching & removing the placenta from the uterus. Perform this procedure in a hospital setting under anesthesia.

Prophylactic Antibiotics

Healthcare providers may administer prophylactic antibiotics during the third stage of labour to prevent infection.

In this section, we will discuss Other techniques to manage 3rd stage of Labour.

Other Techniques to Manage the Third Stage

During the third stage of delivery, there are other techniques that can help manage the process of delivering the placenta. Here are some examples:

Delayed Cord Clamping

  1. Delay clamping the umbilical cord for a few minutes, usually 1-3 minutes, after the baby’s birth in delayed cord clamping.
  2. This allows the baby to continue receiving oxygen-rich blood from the placenta, which can help prevent anemia and other health problems.

Skin-to-Skin Contact

  1. Place the baby directly on the mother’s bare chest after birth for skin-to-skin contact.
  2. This technique helps regulate the baby’s temperature, heart rate, & breathing. Which can promote bonding between the mother & baby.
  3. Skin-to-skin contact stimulates the uterus to contract & expel the placenta.


  1. Breastfeeding can also help stimulate the uterus to contract & expel the placenta.
  2. Breastfeeding releases oxytocin, a hormone that causes the uterus to contract.
  3. It is important to note that breastfeeding should not be used as the only method to manage the third stage of delivery, but can be used in combination with other techniques.

Gravity-Assisted Positions

  1. Using gravity-assisted positions, such as squatting or standing, can help encourage the placenta to detach & be expelled more quickly.
  2. These positions can also help prevent excessive bleeding by promoting uterine contractions.

In this section we will discuss potential complications during the third stage of delivery:

Potential Complications

Complications can sometimes arise during the third stage of delivery. It is important to be aware of the potential risks & how to recognize and respond to them. Some of the possible complications include:

Postpartum Hemorrhage

Postpartum hemorrhage is excessive bleeding that occurs after the birth of the baby. It is one of the most common complications of the third delivery stage. This can happen due to a number of reasons such as retained placental tissue, tears or lacerations(Lacerations are cuts in the skin that can range from minor to severe) in the birth canal, or failure of the uterus to contract properly. Symptoms of postpartum hemorrhage include heavy bleeding, clots, & low blood pressure. Treatment may involve medications to help the uterus contract, blood transfusions, or surgery in severe cases.

Retained Placenta

Retained placenta is a condition where some or all of the placenta remains in the uterus after delivery. This can cause heavy bleeding, pain, & infection. It is important to recognize the signs & symptoms of retained placenta such as persistent bleeding or abdominal pain. Treatment may involve medication or surgery to remove the retained placenta.

Uterine Inversion

Uterine inversion is a rare but serious complication that occurs when the uterus turns inside out during the third stage of delivery. This can lead to heavy bleeding & shock. Symptoms of uterine inversion include severe abdominal pain & vaginal bleeding. Immediate medical attention is necessary to treat this condition.

Amniotic Fluid Embolism

Amniotic fluid embolism is a rare but potentially life-threatening condition that occurs when amniotic fluid or fetal debris enters the mother’s bloodstream. This can cause severe allergic reactions, cardiac arrest, & bleeding. Symptoms of amniotic fluid embolism include difficulty breathing, low blood pressure, & sudden collapse. Immediate medical attention is necessary to treat this.


In summary, the management of the third stage of labour is a crucial phase that marks the completion of the birthing process. it involves actively or physiologically managing the delivery of the placenta. Preparing for the management of the third stage of labour and being aware of potential challenges & complications can help ensure a safe & healthy birth for both the mother & baby. It is important to discuss any concerns or questions with your healthcare provider to ensure the best possible outcomes. By understanding the importance & significance of the 3rd stage of Labour, we can better support & care for mothers during this transformative time.

Further Reading

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1 Comment

Kaviya · May 30, 2023 at 11:13 pm

Great article! It effectively explores the significance of the childbirth process, emphasizing the importance of the management of the third stage of labour (MTSL) for a successful delivery. Well done!

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