To aid delivery of the placenta, hospitals may request consent to give the mother an injection of syntometrine, a substance that helps the womb contract down very strongly. This is injected into her thigh as the baby's shoulders are easing out. It speeds up the third stage and reduces the amount of bleeding the woman experiences after the birth.

As the uterus contracts, the placenta peels off the uterine wall and drops into the lower segment of the uterus. The midwife watches for the visible stretch of cord to lengthen. This tells her that the placenta is detached from the uterus, and she now pulls gently on the cord to extract the placenta. You may be asked to give a little push to help expel the placenta. The membranes come away at the same time, and the midwife looks carefully to see that everything is complete. A piece of placenta left adhering to the uterus can cause an infection or bleeding later.