The third stage of labor, the placenta birth, is often completely ignored or talked about cursorily even in more “holistic” birth circles. It is WRONGLY assumed that this is the job of someone other than the birthing person.
How did we get to the point where we understand so little about this part of the process? Most doctors and midwives believe we need to “deliver” the placenta for the woman we are caring for. And most unassisted birth folks seem to think placentas must just plop our with little or no effort and that pulling on the cord (whether by mom or by midwife) should never ever happen. This leads to some really perplexing situations all around. We often have people ask in our groups on Facebook about “what to do” when the placenta still isn’t out 2, 4, 16 hours after the baby has been born!!! Often the suggestions are to give herbs, put peppermint oil in the toilet etc, which shows a serious misunderstanding of the anatomy and physiology involved.
If the placenta hasn’t been birthed 2+ hours after the birth of the baby, and there has been bleeding that indicates the placenta has separated, and especially if the mom is feeling crampy or uncomfortable, it is extremely likely that the placenta is JUST.SITTING.THERE in the upper vagina, detached and ready to come out with the right combination of force and gravity. Herbs that contract the uterus are unnecessary because the uterus is likely contracted already (or she would be losing lots of blood and feeling horrible by this point). Herbs that help release the placenta are unnecessary because it is already detached. Peppermint oil will do nothing to coax the placenta to come down and around the pubic bone. This is a physics issue plain and simple!
So what do you do? Mom can do gentle cord traction herself. She could get up and shake her bum around (I have seen this). She could have her midwife give some traction if she is having a hard time with the angle. She or a midwife could use a hemostat on the cord to get a better grip (my fave if all else fails).
Tell us about YOUR experience birthing the placenta.
To learn WAY more, check out our 13 Moons: The Indie Birth Experience, which is a 50+ hour course for parents about all things pre-conception through the postpartum! It includes our webinar Creating the Space: How to Manifest an Undisturbed Third Stage and other resources on this topic, and so many more.