Chapter 13: The birth of the placenta – stage 3 of labor
Give pressure inside the vagina
If nothing else will stop the bleeding, try pressure inside
1. Scrub your hands and put on sterile gloves.
2. Explain to the mother what you are doing.
3. Make your hand as small as possible
and put it into the vagina. Move
your hand to the back of the
vagina, above the cervix, and make
a fist. Do not put your hand in
the womb. Move gently — your
hand will hurt the mother.
4. With your other hand, hold the
womb from the outside. Move the
womb down towards your fist, and
squeeze the womb as you move it. The womb should begin to
5. When the womb feels hard, slowly let go of the top of the womb and take
your other hand out of the vagina. Pull out any clots of blood in the vagina
with your hand.
6. If you know how, start an IV (see page 350).
Watch the woman carefully until the bleeding stops
Keep the womb squeezed down until it is firm and the bleeding stops. If the
mother has any signs of shock (see page 239), treat her for shock and take her
to a medical center right away.
A Book for Midwives (2010)