Another great article on the importance of being patient with 3rd stage and the delaying of cord clamping.
by Maggie Banks (Ph D, RM, RGON) homebirth midwife and midwifery educator The third stage of labour is a powerful and mysterious time; more important than we acknowledge and more complex than we know. These thirty minutes or so, which begin as the mother births her baby and finish as she births her baby’s placenta, are usually uneventful compared to the drama of labour and birth, leading many (including many care providers) to think that the birth is already completed. However, enormous changes are happening in the brain and body of mother and baby, all of which are crucial for their survival in the short, medium and long-term. The substantial contribution of the third stage to species survival predicts that evolutionary investment will be high, with substantial sophistication incorporating multiple systems and adjustments.
For the mother, the major adjustment is the shift from pregnant to non-pregnant and especially the sudden separation of her baby’s placenta, which has been intimately associated with her cardiovascular system for the duration of her pregnancy. As the baby’s placenta peels off her shrinking uterine wall, rather like a postage stamp peeling off a deflating balloon, she must seal the blood vessels on her side so that her uterine blood supply, flowing at one-half to one litres per minute, will not haemorrhage from the torn vessels.
This physiological miracle is accomplished by the mother’s uterine muscle fibres, which begin to contract and retract immediately after birth forming “living ligatures” that tighten like a purse-string, kinking and sealing off each maternal arteriole. The uterine contractions that provoke this life-saving haemostatis are triggered by surges of oxytocin, released in a crescendo from the new mother’s pituitary as she gives birth. Ongoing maternal pulses of oxytocin are released as she gazes at and touches her baby, and as her newborn massages, licks, and finally suckles her breast Matthiesen et al (2001). Maternal oxytocin levels peak around the time of placental expulsion Nissen et al (1995)and, in all mammals, oxytocin plays a major role in switching on instinctive mothering behaviour at this time Nelson & Panksepp (1998).