Birthing the placenta afterbirth

After your baby is born, your uterus (womb) can contract to push out the afterbirth.

There are 2 ways to do this. You can do it naturally or with medication. You can discuss both options with your midwife or obstetrician.

Natural method

When you start to feel pressure, your midwife will check to see if there are signs that the placenta has separated. You will be encouraged to get into an upright position if it is ready. Breastfeeding helps the placenta to separate.

The placenta usually comes out with a few gentle pushes from you. The cord is then clamped and cut after the placenta has delivered. This might sooner if your baby is ill.

During a water birth, you can deliver the placenta in or out of the pool depending on your situation.

Medication or active management method

Your midwife may offer you an injection of oxytocin if:

  • you had interventions during labour and birth such as inductionepidural, instrumental birth or caesarean
  • your bleeding is heavier than normal
  • the placenta isn't separating

The injection helps speed this process up. It helps your womb to contract and prevents heavy bleeding.

During a water birth, you will need to request medication (active management). You will be asked to exit the pool for the delivery of the placenta.

Skin-to-skin contact and first feed

You should have skin-to-skin contact with your baby straight after you give birth. You should have this for at least 60 minutes. Your midwife and birthing team will support this.

In some cases, there may be medical reasons why you can’t hold your baby straight after birth. Your partner or family member can do so instead until you are able.

Most healthy newborns will move towards your breast within the first hour of life. They will look for a breastfeed while in skin-to-skin contact. Your midwife will offer you help with feeding. Breastfeeding soon after birth will help your womb contract.

If you are formula feeding your baby, you will be able to do so with help from your midwife.

Page last reviewed: 4 December 2018
Next review due: 4 December 2021