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Let’s roll through the fourth stage of labour. 


You have just pushed your LAST push.


You’ve puffed and panted your baby’s head out.


You’ve waited in sheer disbelief and exhaustion during a pause between the delivery of your baby’s head and body.


Your partner was already tearing up.


Then alas, one more push and the body slipped out, right onto your chest. 


You’re holding a crying baby.

Joy and excitement wash over you.

The moment seems to stop;

you’re unaware of the extra hospital staff walking in and out of the room for the preparation and clean up of the birth.


You’re just staring at each other in awe, and you’re clutching your baby to your chest. 


That’s the fourth stage of labour. 


Your baby’s introduction to the world and you.


Your baby smells you, and calm quickly against your skin. They’ll be ready to breastfeed in 20 minutes or so. Right now, they’re mostly stunned. They might be covered in soft downy hair all over. They might be covered with sticky, white vernix. The hospital staff will monitor their heartbeat, colour, breathing, and temperature every so often. 


You experience the biggest adrenaline rush. 


A huge hormonal shift happens in your body. You will probably experience some uncontrollable shivering but you’re not cold. This is normal. 


You both experience something indescribable.


So we will not attempt to describe it.


But know that this will be the sensation all this build-up and all the hard work was leading towards. That moment is the big picture underpinning all the events. 








Cramping - You will feel some uterine cramping. Don't worry, nothing like contractions!


This is an awesome thing for your body to do - the uterus muscles clamp down to deliver your placenta and then to stop bleeding from the attachment site of the placenta to your womb.


Bleeding - Believe it or not, there is typically no blood throughout the birth until this stage.


The blood comes from the placenta attachment site. Your bleeding will be monitored regularly after your placenta is  delivered.









Fundal Massage - An unpleasant part after birth is the care provider constantly rubbing your belly. 


It can be a bit painful. There is lots of pressure. 


The reason this is done is to check your uterus and control bleeding. After the placenta is delivered, the uterus contracts itself into a small ball. If you press down at around the belly-button level, you will feel that your uterus is hard like a rock. If your uterus doesn’t feel hard, then this is a bit of a concern. It means that it is not well contracted and there is more chance for extra bleeding. Luckily, the uterine muscles responds to touch. When we rub the belly, it firms up. 


So that’s why this unpleasant but important little procedure is done frequently after birth. 




Perineum Exam and Repair - Shortly after the placenta is delivered your care provider will take a look at your perineum and assess if any tears need to be sutured. 


While you may not want anyone or anything close to that area right now, it is actually beneficial to take a look right away. The immense pressure from the baby being born means that the nerves are still somewhat numb and the sensations dulled. 


Your care provider should ALWAYS inform you of the result of their assessment, their management plan (to suture or not), and have your consent. Some small tears do not necessarily need to be sutured, and while this is a decision usually made at the care provider’s discretion, your preference should also be heard. This is a helpful time for you or your partner to speak up if any care does not make you comfortable. 



Key Points of Perineal Suturing:

  1. You will be given freezing if you don’t already have an epidural. This means you don’t feel the repair. 

  2. You don’t have to worry about the stitches coming apart, but do avoid large strides and drastic movements. 

  3. The stitches do not need to be taken out

  4. You might be able to feel the knot or stitches from the outside. It’s okay. 

  5. As the stitches start to dissolve the knots or pieces might start to come out - they look like little pieces of string and you might find them when going to the bathroom. It’s okay. 

  6. For less intensive tears, healing normally does not differ between suturing or not suturing. 




Breastfeeding, Bonding, Family Time


Finally, we get to the most important part.


While all of the above is going on, THIS is what you will be completely enchanted by: your baby. Your new family.


Skin to skin with any parent is beneficial to everyone, and just so enjoyable for all parties involved. Your baby will recognize your smell, the smell of your breasts. They’ll recognize your voice. They’ll recognize the rhythm of your heart beat and your breaths. 




Just like that, you meet the love of your lives.

A Friendly Note:

Every birther should walk away from their birth feeling like a superhuman.

Sometimes things don't go according to plan. Yet at times even when everything goes perfectly well, the sheer intensity and shock of birth can leave one feeling overwhelmed.


For these reasons, we offer special birth debriefing services in our Private Consultations. 

This is especially for anyone who feels that they have a had a traumatic experience, would like to debrief with a clarity of mind to gain more insight on their birth management, and to find closure and strength in their experience. 

what to expect
what happen in the fourth stage
your physical state
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