Chapter 13: The birth of the placenta – stage 3 of labor
Watch for bleeding after the placenta is born
Womb stays soft
The most common reason a mother bleeds heavily after the birth is because
the womb will not contract. Instead, the womb grows larger and feels soft after the
placenta comes out.
The womb may stay soft because:
• the mother’s bladder is full.
• there is a piece of placenta or
membrane still inside the womb.
• the womb needs more stimulation
to make it contract.
• the womb is infected.
• the womb needs more oxytocin to
make it contract.
What to do
If the womb is soft, there are simple ways to make it firm:
Check the placenta again to see if there is a missing piece
A piece of placenta still in the womb can keep it
from contracting completely.
Help the mother breastfeed
When the baby sucks, the mother’s body
makes its own oxytocin. Oxytocin makes the
womb contract just as it did during labor.
This helps slow the bleeding.
Help the mother urinate
When the mother urinates, her womb may be
able to contract more easily. If she cannot
Breastfeeding makes the womb
contract and stop bleeding.
urinate after 4 hours, she may need to have a
catheter (tube) put into her bladder to help her urinate. See page 352 for how to
help a woman urinate and instructions for using a catheter.
Yes. It’s round
Check it every few
hours. If you
start to bleed, or
your womb feels
soft, rub here
until it gets hard.
Rub the womb
See page 224 for how to rub the
womb. Teach the mother and her
family how to check the womb and
how to rub it to make it contract.
A Book for Midwives (2010)