Placenta Delivery: What to Expect

The placenta is a unique organ of pregnancy that nourishes your baby. Typically, it attaches to the top or side of the uterus. The baby is attached to the placenta via the umbilical cord.

After your baby is delivered, the placenta follows. This is the case in most births. But there are some exceptions.

Delivery of the placenta is also known as the third stage of labor. Delivery of the entire placenta is vital to your health after giving birth. Retained placenta can cause bleeding and other unwanted side effects.

For this reason, a doctor will examine the placenta after delivery to ensure that it is intact. If a piece of placenta is left in the uterus or the placenta doesn’t deliver, there are other steps a doctor can take.

The placenta is an organ shaped like a pancake or disk. It is attached on one side to your uterus and on the other side to the baby’s umbilical cord.

The placenta is responsible for many important functions when it comes to a baby’s growth. This includes producing hormones, such as:

  • estrogen
  • human chorionic gonadotropin (hCG)
  • progesterone

The placenta has two sides. The parental side is usually dark red in color, while the fetal side is shiny and almost translucent in color. After the baby is born, a doctor will examine the placenta to ensure each side appears as it is expected to.

Some people ask to save their placenta and will boil it to eat it or even dehydrate it and encapsulate it into pills. In fact, some people believe that taking the pills will reduce postpartum depression or postpartum anemia. However, scientific studies have not proven these effects.

Other people plant the placenta in the ground as a symbolic gesture of the connection between life and earth.

Some states and hospitals have rules about saving the placenta, so a pregnant person should always check with the facility they’re delivering at to make sure they can save the placenta.

Placenta delivery after a vaginal birth

In a vaginal delivery, after the baby is born, your uterus will continue to contract. These contractions will move the placenta forward for delivery. They aren’t usually as strong as labor contractions.

However, some doctors may ask you to continue to push, or they may press on your stomach as a means to advance the placenta forward. Usually, placenta delivery is quick, within about 5 minutes after having your baby. However, it can take longer for some people.

Often, after you deliver your baby, you’re very focused on seeing them for the first time and may not notice the placenta delivery. However, some people observe an additional gush of blood after delivery that’s usually followed by the placenta.

The placenta is attached to the umbilical cord, which is attached to your baby. Because there aren’t any nerves in the umbilical cord, it doesn’t hurt when the cord is cut.

The American College of Obstetricians and Gynecologists (ACOG) recommends in its 2020 guidelines that unless the cord is wrapped around the baby’s neck, it should not be clamped and cut sooner than at least 30 to 60 seconds after birth. This delay improves your baby’s hemoglobin and iron levels, among other benefits.

Placenta delivery after a cesarean

If you deliver via cesarean delivery (also known as C-section), your doctor will physically remove the placenta from your uterus before closing up the incision in the uterus and stomach.

After delivery, your doctor will likely massage the top of your uterus (known as the fundus) to encourage it to contract and start to shrink. If a uterus cannot contract and become firmer, a doctor may give you medication, such as Pitocin, to make the uterus contract.

Breastfeeding or chestfeeding a baby immediately after birth or placing the baby on your skin (known as skin-to-skin contact) can also cause the uterus to contract.

Regardless of how your placenta is delivered, your doctor will inspect it for intactness.

If it appears that a portion of the placenta is missing, your doctor may recommend an ultrasound of the uterus to confirm. Sometimes, excessive bleeding after delivery can indicate that some placenta is still in the uterus.

A birthing person should deliver the placenta within 30 to 60 minutes after having the baby. If the placenta isn’t delivered or doesn’t come out entirely, it’s called retained placenta.

Reasons the placenta may not fully deliver include:

  • The cervix has closed and is too small an opening for the placenta to move through.
  • The placenta is too tightly attached to the wall of the uterus.
  • A portion of the placenta broke off or remained attached during delivery.

Retained placenta is a major concern because the uterus must clamp back down after giving birth. Tightening the uterus helps the blood vessels inside stop bleeding. If the placenta is retained, a person can experience bleeding or infection.

Retained portions of the placenta after delivery can lead to dangerous bleeding and infection. A doctor will typically recommend surgical removal as quickly as possible.

However, sometimes the placenta is so attached to the uterus that it isn’t possible to remove without also removing the uterus (hysterectomy).

A person is at increased risk for retained placenta if they have any of the following:

  • previous history of retained placenta
  • previous history of cesarean delivery
  • history of uterine fibroids

If you are concerned about retained placenta, talk with your doctor prior to delivery. They can discuss your delivery plan with you and notify you when the placenta is delivered.

The birth process can be an exciting one and one that’s full of emotions. Typically, delivering the placenta isn’t painful.

Often, it occurs so quickly after birth that a new parent may not even notice because they’re so focused on baby (or babies!). But it’s important that the placenta is delivered in its entirety.

If you wish to save your placenta, always notify the facility, doctors, and nurses in advance of delivery to be sure that it can be properly saved or stored.

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