Many women who choose a homebirth opt for a physiological / natural third stage. This means that the baby's cord is not clamped immediately - at least not until the cord pulsations have ceased; the midwife does not pull on the cord, but rather waits for the placenta to be born naturally; and syntocinon (oxytocin) is not given. Instead, the woman is assisted into an upright position, skin-to-skin with her baby. This tends to stimulate the release of the hormones that make the uterus contract to expel the placenta. Midwives do carry syntocinon (oxytocin) at a home birth so that it is ready to use if it is needed for excessive bleeding, but most often it is not needed and instead, we support the natural processes of birthing the placenta.