Some couples may not like the idea of using the synthetic product syntometrine and prefer to let nature take its course, allowing the placenta to come out in its own time. This also reduces the risk of a retained placenta (this happens when the uterus contracts down hard before the placenta is delivered, which may then mean it has to be removed manually).

A natural third stage takes a bit longer, about 30 to 60 minutes, rather than five minutes or so with syntometrine. Putting the baby to the breast can help the natural expulsion of the placenta. The baby sucking on the breast produces a rush of oxytocin, the hormone which causes the uterus to contract.

Some parents wish to let the cord stop pulsating before cutting it, so that the baby gets a little more blood from the placenta. In this case syntometrine should not be given until after the cord is cut.

There are some circumstances where a natural third stage is not possible or is inadvisable, for instance if the umbilical cord is very short or if you have had a very long labour or some bleeding in labour.

If you want a natural third stage, it is important to discuss this with your midwife before your baby is born.