The third stage of labour is the time, lasting about 10 min, between the delivery of the baby and the complete expulsion of the placenta. In most cases, this period is uneventful, laying the foundation for a normal post-partum and puerperium. Nonetheless, alterations in the mechanisms of uterine contraction and placental bed involution are mainly responsible for maternal mortality and morbidity worldwide. Post-partum haemorrhage is an obstetrical emergency characterized by excessive blood loss. It is caused by many pathologic mechanisms, divided into the four T’s: Tone (uterine atony), Trauma (lacerations in the birth canal), Tissue (placental retention) and Thrombin (alteration in the coagulation). This condition requires multidisciplinary management by expert personnel to reduce maternal morbidity and mortality. Prolonged third stage of labour is defined after 30 min. It is more frequent in preterm delivery. It can lead to post-partum haemorrhage by reducing the contractility of the myometrium. Placenta accreta spectrum is a group of conditions characterized by excessive invasion of the trophoblast in the myometrium and surrounding tissue, most often in the context of previous caesarean section and placenta previa. It requires careful planning and excellent surgical skills for its management. Uterine inversion is a rare complication caused by the folding of the uterine fundus into the uterine cavity. It can lead to post-partum haemorrhage by reducing uterine contractility. It requires manual or surgical repositioning of the uterus.