By Lovetti Lafua
Nurse • Midwife • Biologist • Maternal Health Advocate • Human Optimization Researcher
The Most Ignored Stage of Childbirth
What Happens to a Woman’s Body in the First 24 Hours After Birth
Many people believe childbirth ends the moment the placenta is delivered.
The baby has arrived. The placenta has been born. The room fills with relief and celebration. Families focus on the newborn, photos are taken, and it feels like the hardest part is over.
But from my perspective as someone deeply rooted in midwifery wisdom and maternal care, an extremely important stage has just begun.
The fourth stage of labour.
This stage covers the first hours and up to the first 24 hours after birth, when a woman’s body begins a powerful transition from pregnancy to postpartum recovery.
During this short but critical period, the body must work quickly to stabilise itself. The uterus must contract firmly, blood vessels that supported pregnancy must close, hormones must rebalance, and the mother’s body must recover from the intense physical work of labour.
In many ways, these hours are among the most delicate moments in maternal health.
Yet they remain one of the most overlooked stages of childbirth.
The Body’s Urgent Work After Birth
During pregnancy, the placenta attaches to the uterus through an intricate network of blood vessels that supply oxygen and nutrients to the baby.
When the placenta separates after birth, those blood vessels are suddenly left open.
The body must respond immediately.
The uterus begins to contract strongly in order to compress these vessels and reduce bleeding. These contractions are the body’s natural protection against postpartum haemorrhage, one of the leading causes of maternal death worldwide.
One of the most important hormones involved in this process is oxytocin.
After birth, oxytocin continues circulating through the mother’s body, helping the uterus contract and gradually return to its pre-pregnancy size.
But oxytocin does far more than control bleeding.
This powerful hormone also:
- strengthens the bond between mother and baby
- supports early breastfeeding
- encourages emotional connection
- helps regulate the mother’s mood
This is why many midwives protect the first moments after birth so carefully.
Those early minutes are not just emotional — they are biologically important for a woman’s recovery.
What Traditional Midwives Have Always Known
Long before modern obstetric science existed, traditional midwives understood the importance of the hours after birth.
In many cultures, the first hours after delivery were treated with deep respect. Mothers were kept warm, the environment remained calm, and babies stayed close to their mothers.
Today, science is confirming the wisdom behind these traditional practices.
When a newborn is placed skin-to-skin on the mother’s chest, the mother’s brain releases even more oxytocin. This surge strengthens uterine contractions and helps reduce the risk of excessive bleeding.
Breastfeeding has a similar effect.
As the baby begins to suckle, signals travel from the breast to the brain, triggering another wave of oxytocin that supports uterine recovery.
Traditional midwives may not have spoken about hormones, but they understood something deeply important:
Mother and baby must remain together.
Separating them too early can interrupt the natural biological processes that protect the mother and help the baby adapt to life outside the womb.
And this brings us to the profound physical changes that occur during the fourth stage of labour.
References
• World Health Organization. (2018). WHO recommendations: Intrapartum care for a positive childbirth experience.
• World Health Organization. (2012). Prevention and treatment of postpartum haemorrhage.
• International Confederation of Midwives. (2017). Essential competencies for midwifery practice.
• American College of Obstetricians and Gynecologists. (2017). Practice Bulletin No. 183: Postpartum hemorrhage.
• Myles Textbook for Midwives. Elsevier.
• Varney’s Midwifery. Jones & Bartlett Learning.
