Birthing the Placenta — What’s the Best Choice for You?
You’ve just birthed your baby. You’re in awe. You’re skin-to-skin. You’re crying, smiling, exhausted, euphoric…
And then someone says:
“Okay, now we need to get the placenta out.”
Wait, what?
Yep—birth isn’t quite over yet. The third stage of labour involves delivering your placenta, and you have choices about how this happens.
Let’s walk through them, gently and clearly.
🩸 What Are Your Options?
There are two main approaches to birthing the placenta:
1. Active Management
An injection of syntocinon (synthetic oxytocin) is given, usually in your thigh
Your midwife applies controlled traction to the cord (i.e., gently pulls it)
The placenta is usually delivered within 5–15 minutes
This is offered routinely in most NHS settings and is recommended in high-risk situations, such as:
Postpartum haemorrhage in a previous birth
Anaemia
Certain complications during labour
2. Physiological (Natural) Third Stage
No injection, no traction
You allow your body to push the placenta out on its own
Baby stays skin-to-skin and the cord remains intact (delayed cord clamping can continue)
The placenta usually comes within 30–60 minutes, with the help of oxytocin produced by:
Skin-to-skin contact
Suckling or breastfeeding
Staying warm, upright, and undisturbed
🌿 Why Choose a Physiological Third Stage?
If your birth has been low-risk and straightforward, and you’re feeling well, you may wish to avoid interventions in the third stage too.
Benefits of a physiological third stage:
Avoids synthetic hormones if you’d rather not use them
Can be gentler and more in tune with your body’s rhythm
Encourages continued oxytocin flow for bonding and breastfeeding
Aligns beautifully with undisturbed, home-based births
It’s worth noting that if the placenta isn’t delivered after 60 minutes, or if there are signs of bleeding, your midwife may recommend moving to active management. This can be done smoothly, with your consent, and doesn’t mean anything has “gone wrong.”
🧠 How to Support a Physiological Third Stage
Here’s what helps your body birth the placenta naturally:
Stay warm: Cold = adrenaline = stalled oxytocin.
Skin-to-skin: Keep your baby on your chest.
Stay upright or forward-leaning: Gravity helps!
Feed your baby or gently stimulate nipples: This boosts oxytocin.
Ask not to be disturbed: No exams, conversations, or rush—just your moment.
You can include your preference for a physiological third stage in your birth plan—but remember, the key is flexibility with full information.
🗒 A Note on Cord Burning or Lotus Birth
Some people planning a home birth also explore:
Lotus birth (leaving the cord and placenta attached until it naturally separates)
Cord burning (a slow, symbolic alternative to clamping)
These practices are rare, but worth researching if you're drawn to a more ritualised or holistic approach.
✨ Final Thoughts
The placenta is part of your baby’s journey—and it deserves attention too.
Whether you choose active or physiological management, the most important thing is that:
You’re informed
You feel safe
You’re supported in your choice
Want help writing a birth plan that includes your third stage preferences?
🎓 That’s covered inside Every Birth Education—or we can explore it one-to-one.