The birth of a baby does not sign the end of childbirth. This really ends with the delivery, that is to say the expulsion of the placenta. A very important step, which is the subject of special attention. The explanations of Anh-Chi Ton, midwife.

After long hours of labor and intense pushing efforts, baby is finally here! For the young mother, however, the mission is not yet completely over. One final step remains: deliverance.

Deliverance: what is it?

Vaginal delivery takes place in several stages: labor, which corresponds to the dilation phase of the cervix, expulsion, that is to say the descent of the baby into the pelvis and then its birth, and finally, what is called deliverance. ' Deliverance is the release of the placenta after childbirth. ' , explains the midwife.

When does deliverance take place?

Delivery takes place within minutes of delivery. ' After birth, there is usually a pause during which nothing more happens. But there is still oxytocin secretions , the hormone that causes contractions. The uterus will therefore begin to contract again in order to expel the placenta. ', details Anh-Chi Ton. When the delivery is spontaneous, the exit of the placenta, the cord and the membranes is done alone.

' The placenta may come out after 10 or 20 minutes . But beyond 30 minutes, you have to intervene to get the placenta to avoid bleeding, the major risk when it stays inside.' , adds the midwife. Normally, the delivery is accompanied by a blood loss which must be less than 500 ml during a vaginal delivery.

Deliverance: how does it work?

When the contractions resume, the woman must again make pushing efforts to expel the placenta. Nothing to do of course with the expulsion of the baby, the exit of the placenta is generally very fast. When it comes out, the midwife examines it carefully to make sure it is complete and that no pieces have remained inside the uterus. During a caesarean section, the obstetrician himself removes the placenta from the uterus using his hands after taking the baby out.

The different types of delivery

• Spontaneous or natural delivery

We speak of natural deliverance when there is no external intervention. The placenta comes out on its own within minutes of delivery as contractions resume.

• Directed deliverance

Directed delivery is the protocol in all hospitals in order to avoid the hemorrhage of delivery as much as possible. ' During the expulsion, when the baby's head is already out and one shoulder is out, a little oxytocin is injected directly into the infusion. The time that the product acts, it allows the placenta to come out more quickly after childbirth. It gives impetus “, explains the midwife. This protocol, applied in 99% of deliveries, reduces the risk of haemorrhage during delivery by 50%.

• The artificial deliverance

When the placenta does not come out after 30 minutes, it is necessary to intervene. ' The midwife will put on very long people, which go up to the elbow, and pick up the placenta herself from the uterus with her hand. We are talking about artificial delivery because it requires outside intervention and that the woman does not do it alone “, details Anh-Chi Ton.

The Hemorrhage of Deliverance: What is it?

We speak of postpartum hemorrhage when there is bleeding after childbirth. . ' After the baby comes out, the uterus contracts, tightens to prevent bleeding. Gold when a piece of placenta remains inside, it cannot contract and therefore it bleeds . We are talking about retained placenta. , explains the midwife. 'I So you have to do what is called a uterine revision by going to manually remove what remains in the uterus' she adds.

Thanks to Anh-Chi Ton, midwifeSource journaldesfemmes.fr