Pregnancy - After Delivery

From the time of the baby's delivery to about four hours after the placenta has been delivered is the final stage of the pregnancy and delivery process. Most complications, especially excessive bleeding, happen at this time. It is important that a woman be closely monitored during this time.

Once the baby has been born, the doctor will put a hand gently on the upper part of the uterus to check for contractions. Usually after one or two contractions, the placenta will separate and be pushed from the mother's body, usually with a gush of blood behind it.

The mother can help with this by pushing. If she can't and if there is a lot of bleeding, the placenta can usually be delivered by firm, downward pressure on the uterus. This is done only if the uterus feels firm. If this doesn't work, the umbilical cord is held tight while the firm uterus is pushed upward away from the placenta.

If the placenta cannot be delivered within an hour of the baby's delivery, it may need to be removed by hand.

Once removed, the placenta should be examined to see that it is complete. Fragments left behind can cause bleeding or infection. If the placenta isn't complete, it may be necessary to examine the uterine cavity by hand.

Once the placenta has been delivered, a woman is usually given a drug containing oxytocin, a natural hormone that makes the uterus contract and helps in the secretion of milk.

The doctor will check the woman to make sure that there are no tears that need to be repaired in the vagina or cervix, to make sure the uterus is contracting and to repair the episiotomy, if one was done.

The mother may then be taken to the recovery room with the baby if all is well. Many mothers want to start breastfeeding soon after delivery. This is good to do. Mother, baby and father or other supporter who was present at the delivery should stay together in a warm, private area for an hour or more. This helps increase parent-baby bonding. The baby may then be taken to the nursery.

The mother should be watched for about an hour to make sure that there is no bleeding or blood pressure problems and that she is well.