Your labor is over! Your sweet baby is finally in your arms and the tough job of childbirth is nearly complete. All that remains is tying up the loose ends, so to speak, and this means the delivery of your placenta, also known as the afterbirth.
It may seem a little anticlimactic ("it's a placenta!"), but this part of labor and delivery is actually a very important moment and, for some, it’s quite symbolic.
During pregnancy, this amazing organ provides everything your baby needs (including nutrition, water and oxygen), and removes what he doesn’t (waste products like carbon dioxide). The placenta’s delivery represents the end of an era as your baby’s uterine home, and the beginning of a new one, his life on the outside.
For more about how this final stage of labor usually plays out, whether there’s any pain involved and what happens to the placenta after it’s delivered, read on.
What does the placenta look like?
The placenta is a flat organ that resembles a disk and is attached to the umbilical cord. This incredible organ has been growing in your uterus during your entire pregnancy, working to give your baby-to-be all the vitamins, minerals and oxygen he needs via the umbilical cord.
What does it mean to deliver the placenta?
Delivering the placenta vaginally is the third stage of labor and it occurs after you’ve pushed the baby out of your birth canal. As you deliver the placenta, you’ll experience mild contractions that last about a minute each (though you may not even notice them, if you can believe it) that will help separate the placenta from the uterine wall and move it along toward the exit so that you can expel it.
The doctor may also help speed up the placental delivery by either pulling the umbilical cord gently with one hand while pressing and kneading your uterus with the other, or exerting downward pressure on the top of your uterus, asking you to push. You can expect this last stage of childbirth to last about 20 minutes, though if you’ve had a C-section, your doctor will simply remove the placenta during the procedure.
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Once the placenta is out, your practitioner will examine it to make sure it’s intact and, in some cases, it’ll be sent to the pathology department if you experienced any complications during its delivery. If you’re planning on taking your placenta home, now’s the time to speak up (more on that below).
Does delivering the placenta hurt?
Delivering the placenta feels like having a few mild contractions though fortunately, it doesn’t usually hurt when it comes out. Your doctor will likely give you some Pitocin (oxytocin) via injection or in your IV if you already have one. This drug will encourage uterine contractions, which in turn speeds the expulsion of the placenta, helps shrink the uterus back to size and also minimize bleeding.
Once the placenta is out, all that’s left to do is for your practitioner to stitch up any vaginal or perineal tears (if you’re not already numbed, you’ll get a local anesthetic) and clean you up. You’ll likely get an ice pack to put on your perineum to minimize swelling, but you can ask for one if it’s not offered.
The nurse will help you put on a maxi pad or add some thick pads under your bottom, since you’ll still be bleeding. Once you’re up for it, you’ll be transferred to a postpartum room (unless you delivered in a LDRP — a labor, delivery, recovery and postpartum — room, in which case you’ll get to stay put).
What is a retained placenta?
The goal during this third phase of childbirth is to expel the placenta within about 30 to 60 minutes after the baby is out. If this doesn’t happen, it's known as retained placenta, a condition that can cause severe — and even fatal — bleeding and serious infection if left untreated.
The reasons for a retained placenta could be due to a number of factors. For some, the placenta may be stuck behind a partially closed cervix, leaving little room for it to exit. In other cases, the placenta, or a piece of it, may still be attached to the uterine wall. Surgery may be necessary to remove the placenta or possibly a hysterectomy if the organ can’t be removed on its own. Luckily, retained placenta is very rare and only occurs in about 2 to 3 percent of all deliveries.
What happens to the placenta after birth?
Once you’ve delivered, the placenta may be sent to pathology to be examined if you had any complications during labor. But if everything went smoothly, you have a few options when it comes to the post-birth placenta. Some patients want to take it home and bury it in a designated spot, which is a tradition in certain cultures.
You may have heard that some women choose to eat the placenta, which is called placentophagy. The reason? Proponents of the practice believe that by eating the afterbirth, women may be able to minimize the risk of anemia (since the organ is high in iron), increase their breast milk supply, rebalance their hormones and possibly lower the chances of developing postpartum depression or PPD.
Keep in mind that there are no large studies to support eating the placenta and, in fact, there may be some health concerns related to this practice. Mainstream medical experts overwhelmingly say that there’s no proven reason to eat your placenta, and the Centers for Disease Control and Prevention (CDC) warned against it after a newborn whose mother ate contaminated placenta capsules was infected with Group B strep.
Whatever choice you make regarding the placenta after you’ve delivered, know that hospitals usually want this organ picked up and taken out of the facility within a certain time frame. If you do choose to eat your placenta despite the risks, you should arrange for it to be properly refrigerated and picked up from the hospital relatively soon after giving birth, then send it out to be professionally prepped and follow safe-prep practices.
Bottom line? Try not to worry about this final stage of labor! It’s usually short, mostly pain-free and may result in some quick stitching while you cuddle your sweet baby and bond as a new family.
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