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We love it when a student turns in exceptional assignments with great information that is informative and thorough. Sharing Courtney’s assignment on Physiologic Third Stage of Labor from our Labor and Birth Doula Course. Fantastic job, Courtney!

Photo by Ksenia Chernaya from Pexels

What is involved in a normal physiologic 3rd stage?

-First and second stage of labor have been physiological
-The birthing person is in a quiet, private environment
-The cord is left intact until the placenta is born
-Medical personnel keep their “hands off” the fundus
-The birthing person and baby stay together with immediate and sustained skin to skin contact
-The birthing person and baby are kept warm
-Self-attachment breastfeeding is encouraged
-The birthing person is in an upright position to encourage the birth of the placenta
-The provider unobtrusively observes for signs of separation of the placenta
-Placenta is birthed entirely by the birthing persons efforts and gravity
-Medical team applies no cord traction
-Medical team does no fundal meddling or massage
-The provider gently encourages the birthing person to be “present” and mindful, to focus on baby while aware of the placenta that is yet to be born
-Partner/support people ensure interactions remain focused on the birthing person and baby
-There is space held with no stress, fear, or prescribed timeframes

What important decision needs to be made before labor has even started in order to have a physiologic 3rd stage labor?

In order to have a physiologic third stage of labor the birthing person must have a physiologic first and second stage as well, it is important to discuss this with the birthing person so she can understand and make an informed decision.

What factors can the doula help with during labor to make sure this is a possibility?

A doula can help make sure the birthing person is well informed of their choices, and the possible risks, benefits, and implications of those choices before labor even begins. A souls can help the birthing person/family communicate their wishes effectively with the medical provider/team. A doula can help the birthing person feel confident in their abilities to have the birth they want, and support the birthing person through it. A doula can help the birthing person to be as comfortable as possible and manage pain in alternative ways. A doula can help with positioning and techniques to get baby into the best position so things have a greater chance of running smoothly.

What factors must the medical personnel be involved with medically?

In physiologic third stage labor the medical team should observe in a “hands off” manner to see when the placenta shows signs of detaching naturally. Then they must observe to make sure there are no signs of hemorrhaging. The medical team should observe in the same “hands off” manner to see whether or not baby is in need of medical attention, if not then the medical team should encourage and allow the birthing person and baby to bond.

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