A mother will often have another surge to push the placenta out after it has self-detached from the uterine wall. This process can happen as soon as a few minutes after birth and up to an hour after birth. In normal circumstances, if a mother is not having excessive bleeding, waiting for the placenta to be birthed on its own has optimal outcome. Encouraging the mother to breastfeed often and early after birth causes the uterus to involve, detaching the placenta naturally. In some circumstances (such as hemorrhage, placental abruption or retained placenta), the placenta may need gentle facilitating to be birthed. This is also called putting traction on the placenta and is done by gently tugging on the umbilical cord. This needs be performed with caution so that more bleeding isn’t caused. Tugging too hard can cause the umbilical cord to snap from the placenta. The placenta should never be pulled out immediately after birth.