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Childbirth practitioners are divided on the issue of delivery of the placenta in water. Physicians and midwives who allow women to deliver the placenta in the water report that it is safe and without side effects. Using this method, the umbilical cord is not cut or clamped until the placenta is out of the woman's body. Doctors and midwives have observed that there is less bleeding and that the babies almost always start nursing immediatly after birth, which helps with the expulsion of the placenta. Some midwives state that the time allowed for the passage of the placenta increases slightly with birth in water. It is their general feeling that the water relaxes the uterus and that the contractions for birthing the placenta are less effective when a woman stays in the water after the baby's birth. When some women stand up to get out of the tub, however, the placenta virtually falls out. -Barbara Harper, RN, "Gentle Birth Choices," Healing Arts Press, 1994
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