Third Stage of Labour

The ‘third stage of labour’ or simply ‘third stage’ lasts from the birth of the baby until the placenta and membranes are delivered and bleeding is controlled.

For many women the third stage can pass almost unnoticed as it follows the birth of their baby who is then the focus of their attention.

Third stage may be left to proceed naturally, often called a ‘physiological third stage’ or it can be managed with a package of interventions aimed at preventing problems with blood loss, often called an ‘active third stage’.

The differences between physiological third stage and active third stage are shown in the table below.

Physiological or natural third stage	Active or managed third stage
No drug given	Drug given to make the uterus contract (‘uterotonic’)
Cord not clamped until it stops pulsating	Cord cut and clamped following birth of baby, sometimes immediately although in some circumstances it may be delayed
No traction (pulling) applied to cord	Controlled cord traction where cord is pulled gently to help deliver the placenta
Placenta delivered through woman's effort	Placenta delivered by midwife or birth attendant
Process may take from a few minutes to over an hour (average about 30 minutes)	Process takes 4 to 7 minutes
Can happen for women at low risk of PPH but could be chosen by women at increased risk	May be given routinely for all women or only for women at increased risk of PPH
Not usually recommended if there have been medical interventions during labour	Usually recommended if there have been interventions during labour
[More information]	[More information]

For more information about choosing between a natural third stage or a managed third stage, click here.