Assessment during the third stage of labor includes:
• Monitoring placental separation by looking for the
following signs:
• Firmly contracting uterus
• Change in uterine shape from discoid to globular
ovoid
• Sudden gush of dark blood from vaginal opening
• Lengthening of umbilical cord protruding from
vagina
• Examining placenta and fetal membranes for intactness
the second time (the health care provider assesses the
placenta for intactness the first time) (Fig. 14.18)
• Assessing for any perineal trauma, such as the following,
before allowing the birth attendant to leave:
• Firm fundus with bright-red blood trickling: laceration
• Boggy fundus with red blood flowing: uterine atony
• Boggy fundus with dark blood and clots: retained
placenta