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Pieces of placenta left behind after birth
What You Should Know About a Retained Placenta
Written by WebMD Editorial Contributors
Reviewed by Dan Brennan, MD on March 11, 2021
In this Article
Causes of a Retained Placenta
Symptoms of a Retained Placenta
Risks of a Retained Placenta
Treatment for Retained Placenta
The placenta is a temporary organ that grows during pregnancy to filter oxygen, blood, and nutrients to your baby. After you give birth, you will also deliver your placenta shortly after.
Sometimes all or part of the placenta stays in the womb. This is called a retained placenta and it can have serious side effects.
Causes of a Retained Placenta
After your baby is born, you will usually deliver your placenta within 18 to 60 minutes. Your uterus contracts, which pulls the placenta away from the wall of your uterus and pushes it out. Sometimes this doesn’t happen and can be caused by different things, including:
Not enough contractions
The placenta grows into the uterus wall
The cervix closes
Giving birth many times
Previous surgery in the uterus
Conceiving by in vitro fertilization
Having a retained placenta in another pregnancy
Being born with uterus deformities
Having oxytocin medication for too long
The most common reason for a retained placenta is not enough contractions in the uterus. Contractions can slow down or the uterus can have trouble contracting for different reasons. These include:
Having large babies
Giving birth many times
Too much oxytocin medication
A long labor
A fast labor
Having twins or multiples
Magnesium sulfate infusions
Symptoms of a Retained Placenta
The most obvious sign of a retained placenta is that you don’t deliver it. The most common symptom of a retained placenta after birth is sudden blood loss and life-threatening bleeding.
At times you might push out most of it, however, some pieces of the placenta can be stuck inside. This can cause symptoms that take a while to show up such as:
Delayed and heavy bleeding
Feeling sick or flu-like
Foul-smelling vaginal discharge
If you have heavy bleeding and blood clots at home, make sure to keep your pads and show them to your doctor right away. They may want to check for placenta tissue.
Risks of a Retained Placenta
Most women safely deliver the placenta after having a baby, but sometimes it can stay inside the womb. This can cause serious side effects.
Life-threatening bleeding. If your placenta is not delivered, it can cause life-threatening bleeding called hemorrhaging.
Infection. If the placenta, or pieces of the placenta, stay inside your uterus, you can develop an infection.
A retained placenta or membrane has to be removed and you will need to see your doctor right away. If you have major bleeding, this is a medical emergency and you should go to your nearest hospital immediately.
Treatment for Retained Placenta
Some conditions can make it more likely that your uterus won’t contract properly. This can lead to a retained placenta. Your doctor will carefully check your medical history and consider how many births you’ve had and what kind of births. They might make plans during your pregnancy that can help ensure you won't have a retained placenta or prepare for retained placenta treatment.
Your doctor or midwife will also usually ask you to do a few things right after giving birth that can help prevent a retained placenta.
Breastfeeding. Your doctor, midwife, or nurse will likely ask you to start breastfeeding your baby as soon as possible after you give birth. This is because breastfeeding makes your uterus contract and is a natural process that will help prevent a retained placenta.
Changing positions. Your doctor might ask you to roll to the side or to squat. Changing positions can help your uterus contract and push out your placenta.
Massage. After delivery, your doctor might massage your abdomen to help it contract. This can feel uncomfortable but can be helpful. Abdominal massage is often used after your second birth. This is because your uterus might not contract very well if you’ve had several births.
Medication. If these methods don’t work, your doctor might give you a shot of medicine that will make the uterus contract and help you deliver your placenta.
Manual removal. If your doctor diagnoses you with a retained placenta, they may want to remove the placenta by hand. They will often try another method first. Your doctor will give you an epidural or anesthetic medicine and manually separate the placenta inside the uterus.
Surgery. If massage, medication, or other options don’t work, your doctor might decide to do surgery. You will have an operation to safely remove the placenta. If the placenta has grown into the uterus wall and invaded other tissues, you may need to have your uterus removed.
Having surgery or a manual placenta removal can have risks, including infection and life-threatening bleeding. It can also cause endometritis, which is inflammation in the uterine lining. Your doctor may give you antibiotics to help stop infection and endometritis.
A retained placenta is not very common, but it can happen. Part of giving birth to a baby is also pushing out your placenta and your doctor will closely watch for it to come.
Retained placenta | Pregnancy Birth and Baby
Retained placenta | Pregnancy Birth and Baby beginning of content
A retained placenta is when the placenta is not delivered within 30 minutes of the baby’s birth. It is a serious problem since it can lead to severe infection or life-threatening blood loss.
Retained placenta is not a common condition, but because it’s serious, it will need to be managed by a medical team.
What causes retained placenta?
A placenta can be retained if your contractions aren’t strong enough to expel it, or if the cervix closes and traps the placenta inside your uterus.
You are more at risk of a retained placenta if you are over the age of 30, have a premature baby or if your first and second stages of labour were very long. It can also happen if you have a fibroid or another problem with your uterus.
Many women will have an injection of syntocinon (a synthetic version of the hormone oxytocin), which not only helps deliver the placenta but also helps reduce the risk of postpartum bleeding. Having this injection is called ‘active management’. If the mother chooses not to have the injection, it is called ‘expectant management’.
What are the symptoms of retained placenta?
The main symptom of retained placenta is that the placenta doesn’t completely come out of the uterus after the baby is born. Another symptom can be bleeding before the placenta comes out.
If a piece of placenta is left behind, you may develop symptoms days or weeks after the birth. These may include:
a bad smelling discharge from the vagina
large pieces of tissue coming out of the vagina
What is the treatment for a retained placenta?
Sometimes retained placenta can be treated simply if you empty your bladder, change position and have the doctor or midwife gently pull on the umbilical cord.
If that doesn’t work, you will need a procedure to remove the placenta. You will be taken into surgery after the birth and given an epidural or anaesthetic so you don’t feel anything. Your doctor will use an instrument called a curette to scrape away the lining of the uterus.
While you’re waiting for surgery, the medical team will keep a close eye on you to check you're not bleeding heavily (postpartum haemorrhage). The procedure itself is quick, but you will need to be monitored for several hours after to make sure you are not bleeding.
If you do start to experience some of the symptoms mentioned above in the days and weeks after you have had your baby, it’s important to see your doctor immediately. It is not always obvious after the placenta has been delivered that some tissue may have been left behind and this can lead to infection and bleeding. If you are bleeding heavily after the birth, you will need surgery to investigate the cause.
RANZCOG (Management of Postpartum Haemorrhage (PPH)), King Edward Memorial Hospital (Retained placenta), Women's and Newborn Health Westmead Hospital (The birth of your placenta), International Journal of Women's Health (Retained placenta after vaginal delivery: risk factors and management)
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Last reviewed: February 2020
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Postpartum haemorrhage is when you bleed more than normal after giving birth. It can be very serious and requires medical attention right away.
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What is done with the placenta after childbirth. Gynecologist's column
Why do we say these phrases?!
Separation of the placenta from the wall of the uterus usually occurs within 15 minutes after the birth of the baby. If this does not happen, we ask the woman to stimulate the nipples, as this produces oxytocin, which causes uterine contractions. This contributes to the separation of the placenta and the release of the placenta.
When the separation of the placenta has occurred (we have our own methods for determining this moment), we ask the woman to push so that the placenta is "born" out. Don’t worry, you don’t need to push as hard as when giving birth, because the afterbirth is much smaller and much less effort is needed to deliver it.
If there are no signs of separation of the placenta within 30 minutes or the placenta was born with a defect (a small part of it is missing), we call an anesthesiologist and apply techniques for the separation of the placenta, which are carried out strictly under anesthesia.
Photo source: pixels.com
In any case, the placenta will be born, either by "own will" or with the help of obstetricians.
Unfortunately, there are cases of true placenta accreta, when it can be removed from the woman's body only together with the uterus. But these cases are extremely rare.
What happens to the placenta after childbirth?
In 95-98% placenta is sent for histological examination to pathologists . Right in the delivery room, the midwife puts the placenta in a bag, marks it, and the obstetrician-gynecologist writes an accompanying referral, which indicates the data of the woman and the child and all the moments that complicate pregnancy and childbirth.
Then the placenta is placed in a special refrigerator until the centralized collection of all placentas born in a day (a special car arrives to take the placentas to pathologists). This is what happens in most cases.
But if the placenta is of no interest, ie. the pregnancy went perfectly (there was not even a thrush, SARS, etc.), there was not a single complicating moment in childbirth, then the placenta is not sent for histological examination and the maternity hospital itself is engaged in its disposal, or rather, an institution licensed for such activities with which This home has a contract.
The same afterbirths that were sent to the pathologists are being carefully analyzed. Experts make a conclusion, after which they dispose of the material.
Photo source: uaua.info
Destroying the myths about the placenta
At the moment in the Republic of Belarus no contracts are concluded with other countries for the supply of placenta for the purpose of using them for cosmetic purposes. All afterbirths are strictly subject to disposal.
Therefore, terrible stories that after giving birth to a woman who does not give an account of her actions, some documents are slipped for signature on the transfer of her placenta for the manufacture of creams - this is a myth.
the placenta must be eaten or instilled
More and more women want to take their placenta home with them after giving birth. Each pursues its own goal. Someone is afraid that the placenta will be sold to cosmetics manufacturers, we have already dealt with this point.
But there are also completely absurd ideas: to eat or bury the placenta. Where did they go?!
This is what animals do in the wild. Why? For many reasons. They are buried so that predators do not smell the blood. They are eaten to obtain nutrients, since in a deeply pregnant state it was difficult to find food and many animals have to starve on the eve of childbirth. But why do we, civilized women?!
Predators are not our topic at all, and there are plenty of nutrients in any hypermarket. In some countries, and in our time, there is the practice of eating placentas after childbirth, but these are just those countries where cannibalism was practiced.
I heard that in some civilized countries pieces of the placenta are wrapped in silver or gold and worn like a pendant around the neck. What can not be invented in our time!
But let's get closer to reality. In the Republic of Belarus, you cannot take the placenta home with you!
According to the order of the Ministry of Health of the Republic of Belarus No. 111 “On further improvement of the pathoanatomical service of the Republic of Belarus:
Histological preparations can be issued to a patient, his relatives or medical personnel for consultation in another medical institution upon an official written request from this institution. The medical institution to which the drugs were issued is obliged to return them to the pathoanatomical department. Handing out study forms to patients is prohibited
We can sleep peacefully without worrying ourselves about the fact that at the moment someone is applying a cream from our placenta to our face, and at the same time we are not looking for a safer place to bury it.
Diana Mardas, Head , author of courses, obstetrician-gynecologist practicing in the maternity hospital, certified specialist in the field of breastfeeding, management of pregnancy and high-risk childbirth, pregnancy psychology, developer of the assessment scale for the occurrence of cerebral palsy in a child, author of numerous publications in the field of pediatrics, obstetrics and gynecology, medical law, student of international and republican conferences in the field of obstetrics and gynecology.
The body of a woman was created by nature so that she could conceive, bear and give birth to healthy offspring. Each step on the way to this miracle is "thought out" to the smallest detail. So, to provide the baby with everything necessary for 9 months, a special organ is formed - the placenta. She grows, develops and is born just like a baby. Many women who are just about to have a baby ask about what an afterbirth is. This is the question that will be answered below.
Development of the placenta
A fertilized egg travels from the fallopian tube to the uterus before becoming an embryo and then a fetus. Approximately 7 days after fertilization, it reaches the uterus and implants in its wall. This process takes place with the release of special substances - enzymes that make a small area of the uterine mucosa loose enough so that the zygote can gain a foothold there and begin its development already as an embryo.
A feature of the first days of embryo development is the formation of structural tissues - chorion, amnion and allantois. Chorion is a villous tissue that communicates with lacunae formed at the site of destruction of the uterine mucosa and filled with maternal blood. It is with the help of these outgrowths-villi that the embryo receives from the mother all the important and necessary substances for its full development. The chorion develops within 3-6 weeks, gradually degenerating into the placenta. This process is called the word "placentation".
Over time, the tissues of the embryonic membranes develop into important components of a healthy pregnancy: the chorion becomes the placenta, the amnion the fetal sac (bladder). By the time the placenta is almost fully formed, it becomes like a cake - it has a fairly thick middle and thinned edges. This important organ is fully formed by the 16th week of pregnancy, and together with the fetus, it continues to grow and develop, properly providing for its changing needs. This whole process experts call "ripening". Moreover, it is an important characteristic of the health of pregnancy.
Determine the maturity of the placenta by performing an ultrasound examination, which shows its thickness and the amount of calcium in it. The doctor correlates these indicators with the gestational age. And if the placenta is the most important organ in fetal development, then what is the afterbirth? This is a mature placenta that has fulfilled all its functions and was born after the child.
The structure of the protective shell
In the vast majority of cases, the placenta is formed along the back wall of the uterus. Tissues such as cytotrophoblast and endometrium take part in its origin. The placenta itself consists of several layers that play a separate histological role. These membranes can be divided into maternal and fetal - between them is the so-called basal decidua, which has special depressions filled with the mother's blood, and is divided into 15-20 cotyledons. These components of the placenta have a main branch formed from the fetal umbilical blood vessels connecting to the chorionic villi. It is thanks to this barrier that the blood of the child and the blood of the mother do not interact with each other. All metabolic processes occur on the principle of active transport, diffusion and osmosis.
The placenta, and, therefore, the placenta that is rejected after childbirth, has a multilayer structure. It consists of a layer of fetal vascular endothelial cells, then comes the basement membrane, connective pericapillary tissue with a loose structure, the next layer is the basement membrane of the trophoblast, as well as layers of syncytiotrophoblast and cytotrophoblast. The placenta and placenta are defined by specialists as a single organ at different stages of its development, which is formed only in the body of a pregnant woman.
Functions of the placenta
The afterbirth, which is born some time after the birth of the child, carries an important functional load. After all, the placenta is exactly the organ that protects the fetus from negative factors. Its functional role is defined by specialists as the hematoplacental barrier. The multilayered structure of this "cake", connecting the growing, developing fetus and the mother's body, allows you to successfully protect the baby from pathologically dangerous substances, as well as viruses and bacteria, but at the same time, through the placenta, the child receives nutrients and oxygen, and through it also gets rid of products of their life. From the moment of conception and a little longer after childbirth - this is the "life path" of the placenta. From the very beginning, it protects the future life, passing through several stages of development - from the chorionic membrane to the placenta.
The placenta exchanges not only useful, but also waste substances between mother and child. The waste products of the baby first enter the mother's blood through the placenta, and from there they are excreted through the kidneys.
Another function of this pregnancy organ is immune protection. In the first months of a fetus's life, the mother's immunity is the basis of his health. nascent life uses the mother's antibodies for protection. At the same time, maternal immune cells, which can react to the fetus as a foreign organism and cause its rejection, are delayed by the placenta.
During pregnancy, another organ appears in the woman's body that produces enzymes and hormones. This is the placenta. It produces hormones such as human chorionic gonadotropin (hCG), progesterone, estrogens, mineralocorticoids, placental lactogen, somatomammotropin. They are all important for the proper development of pregnancy and childbirth. One of the regularly checked indicators throughout all the months of bearing a child is the level of the hormone estriol, its decrease indicates problems with the placenta and a potential threat to the fetus.
Enzymes of the placenta are necessary for many functions, according to which they are divided into the following groups:
respiratory enzymes, which include NAD- and NADP-diaphorases, dehydrogenases, oxidases, catalase;
aminopeptidase A, involved in the reduction of vascular pressor response to angiotensin II in chronic intrauterine fetal hypoxia;
cystinaminopeptidase (CAP) - an active participant in maintaining the blood pressure of the expectant mother at a normal level throughout the entire period of pregnancy;
cathepsins help the fetal egg implant in the uterine wall and also regulate protein metabolism;
aminopeptidases are involved in the exchange of vasoactive peptides, preventing the narrowing of placental blood vessels and participating in the redistribution of fetoplacental blood flow during fetal hypoxia.
Hormones and enzymes produced by the placenta change throughout pregnancy, helping a woman's body withstand a serious load, and the fetus to grow and develop. Natural childbirth or caesarean section will always be fully completed only when everything that helped the baby grow is removed from the woman's body - the placenta and fetal membranes, in other words, the afterbirth.
Where is the child seat located?
The placenta can be located on the wall of the uterus in any way, although its location in the upper part (the so-called bottom of the uterus) of the posterior wall is considered classical and absolutely correct. If the placenta is located below and even practically reaches the cervix, then experts speak of a lower location. If the low position of the placenta was shown by ultrasound in the middle of pregnancy, this does not mean at all that it will remain in the same place closer to childbirth. The movement of the placenta is fixed quite often - in 1 out of 10 cases. Such a change is called placental migration, although in fact the placenta does not move along the walls of the uterus, as it is tightly attached to it. Such a shift occurs due to the stretching of the uterus itself, the tissues seem to move upward, which allows the placenta to take the correct upper position. Those women who undergo regular ultrasound examinations can see for themselves that the placenta migrates from the lower to the upper location.
In some cases, with ultrasound, it becomes clear that it blocks the entrance to the uterus, then the specialist diagnoses placenta previa, and the woman is taken under special control. This is due to the fact that the placenta itself, although it grows in size with the fetus, its tissues cannot stretch much. Therefore, when the uterus expands for the growth of the fetus, the child's place may exfoliate, and bleeding will begin. The danger of this condition is that it is never accompanied by pain, and at first the woman may not even notice the problem, for example, during sleep. Detachment of the placenta is dangerous for both the fetus and the pregnant woman. Placental bleeding that has begun once can recur at any time, which requires the placement of a pregnant woman in a hospital under the constant supervision of professionals.
Why do we need placental diagnostics?
Since the correct development of the fetus, as well as the condition of the pregnant woman, to a large extent depend on the placenta, close attention is paid to it during examinations. An ultrasound examination of pregnancy allows the doctor to assess the location of the placenta, the features of its development throughout the entire period of bearing a child.
Also, the state of the placenta is assessed by laboratory tests for the amount of placental hormones and the activity of its enzymes, and dopplerometry helps to determine the blood flow of each vessel of the fetus, uterus and umbilical cord.
The state of the placenta plays an important role in the most crucial period - the period of childbirth, because it remains the only opportunity for a baby passing through the birth canal to receive all the substances and oxygen he needs. And that is why natural childbirth should end with the birth of the placenta, which has fulfilled its functions.
Natural childbirth in three stages
If a woman gives birth naturally, then specialists divide such childbirth into three stages:
birth of placenta.
The placenta is one of the most important biological elements throughout pregnancy until the birth of a new person. The baby was born, the "cake" of several layers of tissue and blood vessels of different types played its role. Now the woman's body needs to get rid of it in order to continue to function normally in a new status. That is why the birth of the placenta and fetal membranes stands out in a separate, third stage of childbirth - the discharge of the placenta.
In the classic version, this stage is almost painless, only weak contractions can remind a woman that the birth has not yet been completed completely - the postpartum placenta has separated from the walls of the uterus and must be pushed out of the body. In some cases, contractions are not felt at all, but the separation of the placenta can be determined visually: the bottom of the uterus rises above the navel of the woman in labor, while shifting to the right side. If the midwife presses the edge of her hand just above the womb, then the uterus is understood higher, but the umbilical cord, which is still attached to the placenta, is not retracted. A woman needs to push, which leads to the birth of the placenta. Methods for isolating the placenta against the background of the postpartum period help to complete the pregnancy correctly, without pathological consequences.
What does the afterbirth look like?
So what is afterbirth? It is a rounded flat formation of a spongy structure. It is noticed that with a body weight of a born child of 3300-3400 grams, the mass of the placenta is half a kilogram, and the dimensions reach 15-25 centimeters in diameter and 3-4 centimeters in thickness.
The afterbirth after childbirth is the object of careful study, both visual and laboratory. A doctor examining this life-supporting organ of the fetus in the womb should see a solid structure with two surfaces - maternal and fetal. The placenta on the side of the fetus in the middle has an umbilical cord, and its surface is covered with an amnion - a grayish shell that has a smooth, shiny texture. On visual inspection, you can see that blood vessels diverge from the umbilical cord. On the reverse side, the afterbirth has a lobed structure and a dark brown shade of the shell.
When the birth is completed completely, no pathological processes have opened, the uterus contracts, decreasing in size, its structure thickens, its location changes.
Pathologies of the placenta
In some cases, retention of the placenta occurs at the last stage of labor. The period when such a diagnosis is made by a doctor lasts from 30-60 minutes. After this period, the medical staff attempts to isolate the placenta by stimulating the uterus with massage. Partial, complete increment or dense attachment of the placenta to the wall of the uterus does not allow the placenta to separate naturally. In this case, specialists decide to separate it manually or surgically. Such manipulations are performed under general anesthesia. Moreover, the complete fusion of the placenta and uterus can be resolved in the only way - by removing the uterus.
The placenta after childbirth is examined by a doctor, and if its damage or defects are found, especially if the woman in labor continues to uterine bleeding, then a so-called cleaning is performed to remove the remaining parts of the placenta.
Massage for the placenta
In natural childbirth, it is not such a rare problem - the placenta did not come out. What to do in this case? One of the effective and safe ways is massage to stimulate the uterus. Specialists have developed many methods to help a woman in labor get rid of the placenta and membranes without external intervention. These are ways like:
Abuladze's method is based on gentle massage of the uterus in order to reduce it. Having stimulated the uterus to contraction, the doctor forms a large longitudinal fold on the peritoneum of the woman in labor with both hands, after which she should push. The afterbirth comes out under the influence of increased intra-abdominal pressure.
Genter's method allows the delivery of the placenta without attempts on the part of the woman in labor by manually stimulating the uterine fundus from top to bottom, towards the center.
According to the Krede-Lazarevich method, the placenta is squeezed out by pressing the doctor on the bottom, anterior and posterior walls of the uterus.
Manual removal of the placenta is carried out by internal manipulation - the doctor inserts his hand into the vagina and uterus of the woman in labor and tries to separate the placenta by touch. If this method does not help to achieve its removal, then we can only talk about surgical intervention.
Is there any prevention of placental pathologies?
What is an afterbirth? This question is often heard by gynecologists from women. planning motherhood. The answer to this question is both simple and complex at the same time. After all, the placenta is a complex system for maintaining life, health and proper development of the fetus, as well as the health of the mother. And although it appears only for the period of pregnancy, the placenta is still a separate organ, potentially susceptible to various pathologies. And disturbances in the vital activity of the placenta are dangerous for the baby and his mother. But very often, the occurrence of placental complications can be prevented by fairly simple, natural methods:
thorough medical examination before conception;
treatment of existing chronic diseases;
healthy lifestyle with quitting smoking and alcohol, normalization of the regime of work and rest;
introduction of a balanced diet for the expectant mother;
maintaining a positive emotional background of life;
prevention of infection with viral, bacterial and fungal infections;
intake of vitamin and mineral complexes recommended by a specialist.
Compliance with such natural advice will help to avoid many problems during pregnancy, during childbirth.
So what is afterbirth? This is a special part of the body of a pregnant woman, which ensured the conception, bearing and birth of a new life. This word, which speaks for itself, refers to those born after the child or forcibly removed the placenta and fetal membranes, which served the most important role - helping to form a new life.
Many women naively believe that the process of childbirth is exclusively contractions, attempts and the direct birth of a baby. However, this is not the case, since the birth process consists of several stages, which the mother may not be aware of.
After the baby, so to speak, left the mother's womb, another stage begins - the separation of the placenta. If a woman gave birth for the first time, this stage is unknown to her, hardly imagined. But this does not give cause for concern, since the team of doctors who take birth is obliged to make sure that everything is fine with mom.
What is the afterbirth and how does it come out
The afterbirth is the placenta, umbilical cord and remaining particles of amniotic membranes. These components were formed during the first trimester of pregnancy, playing a crucial role in the life of the baby.
With their help, the baby was protected from external influences of adverse substances, oxygen and micronutrients were supplied through them, and the baby's waste products were excreted.
After birth, the baby leaves the mother's womb, and the need for these formations disappears. In order for the woman's body to fully recover after childbirth, it is necessary to remove the remnants of the placenta and umbilical cord and from the uterine cavity. Due to the fact that this process is carried out last, it acquired the name "last".
What happens when the placenta does not come out on its own
In principle, nature provides that all the remains leave the mother's womb on their own, but in the case when this does not happen, the placenta does not separate on its own, then doctors are forced to forcibly separate it from the abdominal cavity of the woman in labor . The natural birth process implies that at the birth of a baby, the umbilical cord, which has ceased to fulfill its intended purpose, is cut. Thus, the last carnal connection between the baby and the mother is completely cut off, while the uterus, meanwhile, continues to contract, decreasing.
These processes contribute to the speedy delivery of the placenta. Meanwhile, the doctor presses on the lower abdomen to check if the genitals are ready to push out the tissues. In the case when the umbilical cord is not pulled back, it means that the placenta will begin to come out right now. It is absolutely painless for a woman in labor, so you should not worry about this.
The uterus continues to occur, but the woman often does not feel them. Then the doctor asks the woman in labor to push again, after which the placenta comes out within a few minutes.
If the birth was by caesarean section, then due to damage to the organs, the uterus does not contract so actively, so the placenta and umbilical cord may not come out. In this case, the placenta is removed by doctors manually using special tools.
After the placenta comes out or is removed by doctors, specialists examine it for damage, check whether the edges of the membranes are even, without breaks, carefully examine the placenta and its structure. These actions play a fundamental role in the conclusion about how the pregnancy and childbirth went.
After the doctors have examined the placenta, it is disposed of. Today, in extreme cases, he can be given to his mother so that she decides his fate on her own, but often the medical staff treats him at their own discretion.
However, medical professionals may not allow postpartum tissue to be taken with you because it is prohibited by law. At the present time, the fact that the mother wants to take the afterbirth has not gained popularity, often no one even thinks about it.
If the parents have decided to take the postnatal tissues, it is best to determine in advance what will happen to him next. This, of course, depends on the couple's motives and personal beliefs.
It is possible that the placenta will simply be taken away in a bag and then thrown away, but then you should not take it at all from the maternity hospital. In our country, the possibility of preserving stem cells that are extracted from the umbilical cord and stored later in a frozen state is limited.
In Western countries, this practice is quite common and is actively in demand among young families. After separation and freezing, stem cells are stored in separate boxes in a specialized room. With their help, in the future, you can help save the life of a child in the event of serious illness.
One way or another, if the mother decides to keep the afterbirth, she should find an institution that implements this in advance, otherwise, after the birth, it is already pointless to organize this issue, since the afterbirth will be unsuitable for further preservation for a couple of hours.
In Moscow maternity hospitals, it is not uncommon for doctors to ask parents if they want to take the placenta with them. In a home birth, the placenta stays with the baby and parents have to decide what to do with it next. Here are 5 ways to use the placenta after childbirth. In traditional cultures, the placenta is considered the first home of the baby, his spiritual counterpart and even a relative. The placenta is buried in a special place, dried, eaten, and even the first teether for the baby is made from the umbilical cord. Robin Lim, a midwife at the Bumi Sehat center in Bali, has written an entire book on the meaning of the placenta, where she has collected rituals from all over the world. In ancient Russia, the placenta was buried under a tree or in the foundation of a house. The modern tradition is to leave the placenta in the hospital and forget about it immediately after birth. But no one bothers you, if you wish, to come up with a little ritual for your family and save the placenta for yourself and the newborn baby.
Take and eat your placenta
This is traditionally done in some parts of Indonesia, the Czech Republic and Morocco. It is believed that a woman who has eaten her placenta will be fertile. In Mexico, mothers are allowed to chew on the umbilical cord, and in Bali, midwives from Bumi Sehat offer a woman in labor to eat a piece of raw placenta immediately after childbirth to prevent postpartum hemorrhage. Why do some people hate to think about it?
The placenta is the real part of the human body. It is made of human tissue and looks like a piece of fresh flesh. In our society, the ban on eating one's own kind is one of the most ancient. Incidents of cannibalism terrify us. Therefore, the mere thought of eating the placenta is disgusting to many people. It's almost like tasting the human body. Solid Sorokin turns out. That is why encapsulation of the placenta is becoming more common. It seems to be the same in essence, but swallowing pills is a completely different matter, it is just quite traditional and in our society is associated with treatment and benefits. Sometimes 2-3 teaspoons of placenta are added to smoothies (with banana, berries and coconut water), sometimes swallowed like this. There was even a special service for preparing smoothies right in the birthing box, usually parents enter it into their birth plan and pay about $20-30.
Some people make a real dish out of the placenta. We came across recipes for lasagna and placenta spaghetti bolognese. In 1998 Chef Hugh Fearnley-Whittingstall made placenta pâté in his cooking show. And in 2006, Tom Cruise promised to arrange a feast with the placenta after the birth of his wife Katie Holmes. With the exception of whales, almost all mammals in nature do exactly this with the placenta - no, they don’t cook lasagna, but simply take it and eat it whole. In addition to the obvious nutritional value, p Plus oxytocin, which helps the uterus contract and is responsible for the release of milk, and zinc, a mineral that helps prevent postpartum depression. At the moment, there is no reliable scientific data on the benefits or harms of placentophagy. But some researchers became interested in the issue and began to study the effect and composition of the placenta.
Make tablets from the placenta
It's almost like eating, only in a more culturally acceptable way. Over the past 5 years, encapsulation of the placenta has become increasingly popular. In 2013, actress January Jones (Mad Men's Betty Draper) touted placental capsules as a cure for postpartum depression. There are two main ways to encapsulate:
by analogy with Chinese medicine (where the placenta has long been used as a medicine) to dry the placenta together with herbs
in the tradition of raw foodists, use only a dehydrator that does not heat the placenta above 40’
Only fresh placenta (less than 48 hours) that has been refrigerated is suitable for encapsulation. The output is 100-200 capsules, which can be stored in the same place, in the refrigerator. The process itself is most often undertaken by midwives, doulas, or placental encapsulators. Everything takes about 2-3 days and costs $150-250. Sometimes mothers carry out encapsulation on their own (process on the PHOTO). To do this, you need a dehydrator, an apparatus for packaging the placenta powder into capsules and the capsules themselves. You can order special kits on the Internet (about $30), however, you need to get a dehydrator in advance or use an oven. Opinions about pills from the placenta are very different. For example, here's a heartfelt review from Jill Fehrenbacher, founder and publisher of Inhabitots, a hipster site for moms and babies, about her experience with placenta encapsulation. And here is a post of regret from Nancy Redd, a journalist and Harvard graduate who managed to become Miss Virginia in 2010 and receive a bunch of awards for her work in the field of women's health. She writes that taking pills with her own placenta, on the contrary, provoked a deterioration in her mood after childbirth.
Usually among the benefits of taking dried placenta capsules describe the following :
helps to avoid postpartum depression
restores hormonal balance after childbirth
increases the level of iron in the body
Promotes faster cessation of postpartum discharge
gives energy and strength in the first weeks after childbirth
Bury the placenta next to the plant
This tradition has also existed for a long time. In Hawaii, the placenta is planted under a tree. which in the future becomes a tree of a child, and in Sudan the placenta is considered a “spiritual double” and is buried closer to the place of the desired work of the offspring (for example, next to the hospital for the future doctor). Actor Matthew McConaughey did just that with the placenta of his newborn son Levi - he planted it under a tree in an orchard. On the net you can order a special set for rooting the placenta: a bag, a tree tag and a book for the baby about the placenta under his own plant. There is also a whole section about the types of trees and their symbolic meaning. Probably, the druid horoscope is also quite suitable for these purposes. Important! The placenta should be buried deep enough (at least 40 cm), as it can damage the root system of the tree, and local predators can also smell it. You can put the placenta in the freezer and wait six months or a year, then it will become less active.
Most often, the placenta is buried in a place where the family will return for many years. If there is no such place yet, you can choose the option for modern nomads and plant the placenta in a large flower tub. Given the northern climate, this method allows you to expand the choice of totem plants. Last year, at a Sisters Morning Star seminar, one such placenta from the refrigerator was planted in a tub with an orange tree. The sister sang Indian blessings, and most of those present (including the author) even shed tears while participating in this ritual.
Make an imprint with the placenta
There is a way for creative people leave a print of the placenta as a keepsake. To do this, just take a large sheet of paper and beautifully lay the placenta on it. Sometimes the print is made without paints - with the blood that remained on the placenta. In this case, you need to choose acid-free paper for archival storage. If you use gouache, acrylic or watercolor for a print, then ordinary paper for drawing is quite suitable. The placenta is applied to the sheet with the side where the umbilical cord is attached (this is the side of the baby). Then the imprint looks like a tree with a wide crown and tenacious roots.
Make placenta jewelry
Pieces of dried placenta or umbilical cord are epoxy turned into beads or ready-made rings and pendants. Those who know how to handle such things can try to make jewelry themselves. The rest will have to figure out a way to send the placenta to the craftsmen who create such jewelry. For example, in Beyond the Willow, where they promise to build such a bracelet within 2-4 weeks. There are also breast milk rings, but about them another time! In Moscow, I know one jeweler mother who will not be surprised at all by your desire.
What else could be done to the placenta?
In Yemen, the placenta is placed on the roof of the family home and eaten by birds. It is believed that this helps to strengthen the love ties between parents.
Throughout pregnancy, the placenta develops with the baby. This body does not get special attention from the mother. After the birth of a child, the exit of the placenta, many women do not notice at all. However, this is a very significant organ, thanks to which the child develops.
What happens to the placenta after childbirth, and what functions it performs, we will tell in this article.
The placenta is the child's place (afterbirth) that connects the body of mother and child. The placenta is attached to the body of the uterus by blood vessels, with the help of the umbilical cord it connects to the body of the child. Inside the umbilical cord there are 2 arteries that carry blood from the fetus to the placenta. And 1 vein, which serves to transport oxygen and nutrients from the placenta to the fetus.
The placenta performs certain functions throughout pregnancy:
Gas exchange (delivery of oxygen to the fetus). Oxygen molecules through the mother's blood enter the fetus, carbon dioxide is transported in the opposite direction.
Delivery of nutrients to the child: water, vitamins, electrolytes. Excretion of fetal metabolic products through the mother's blood.
Production of hormones to support pregnancy and lactation.
Fetal immune defense function. The placenta passes maternal antibodies through itself, which form the baby's immune defenses.
The child's seat develops with the baby and leaves the uterus after the baby is born.
Delivery of the placenta
After 5-40 minutes after birth, the afterbirth is born. Contractions of the uterus lead to a decrease in the placental site, to which the baby's place was attached. After several contractions, the placenta exfoliates from the wall of the uterus, and the obstetrician asks the woman in labor to push slightly. The placenta is born painlessly and fairly quickly.
After removing the placenta, the doctor carefully examines it. If a violation of the integrity of the placenta is found, this may mean that pieces of the membranes remain in the uterine cavity. They must be urgently removed from the uterine cavity in order to prevent the development of the inflammatory process. Manual examination of the uterus is performed under anesthesia.
By the way the afterbirth looks, one can judge the course of pregnancy. Infectious or inflammatory processes will be visible according to the state of the child's place. This is important information for neonatologists and pediatricians who monitor the health of the newborn.
What happens to the placenta after childbirth
Most women do not even think about what is the fate of the child's place after childbirth. In fact, nothing much is happening. The placenta is a biological material that must be disposed of in accordance with the requirements of this medical institution.
In some cases, the placenta is preserved as directed by a doctor. This is necessary in the case of pathological childbirth. And in the case of a stillbirth, the placenta must be transferred for histological examination to determine the causes of the incident.
Video: Histology of the placenta
Sometimes, with the consent of the mother, the placenta is kept for laboratory testing. The woman can take him home if she wants to. The collection of cord blood and stem cells is a rather expensive procedure, but it is possible by prior arrangement.
In some cultures, the placenta after childbirth has a special relationship. For example, according to one of the signs, the afterbirth is buried under a tree in the courtyard of the house. People believe that the tree as a symbol of strength will bring good health and happiness to the child. Like it or not, depends on what the person believes.
There is a legend that if you eat the placenta after childbirth, it promotes lactation, quickly restores the woman's strength after childbirth. The placenta is, in fact, a piece of human meat. Perhaps in ancient times, when the only source of meat for dinner was a killed mammoth, this was relevant. But now a woman can easily organize a diet without it.
After childbirth - from the first hours to the first weeks
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One of the most common illusions of a future mother is that immediately after childbirth the pregnancy, which lasted 9 months, will completely end, and the female body will immediately return to its original state. What will return is undoubtedly, but that immediately after the birth is a delusion that needs detailed analysis and "exposing". The fact is that after the child is born and grows up every day, the countdown will begin for his mother - gradual return to "pre-pregnancy" state , through overcoming unpleasant sensations, for which one must be prepared. Armed with knowledge, it will be much easier to overcome this difficult period.
postpartum period begins from the moment of the birth of the placenta and continues until the end of the involution (reverse development, i.e. recovery) of all organs and systems that have undergone changes due to pregnancy and childbirth.
So, let's see how events develop - from the first hours to the first weeks.
First 2 hours after delivery (before transfer to the postpartum ward)
In the first few hours after the end of childbirth, the woman remains under the supervision of medical personnel in the delivery room, since during this time various complications are possible, such as bleeding, fever, changes in blood pressure.
In any case, the initial stage of recovery after childbirth is associated with the following manipulations.
First of all, they conduct a study of the state of the uterus: immediately after childbirth, the uterus should be dense. If she is relaxed the midwife does outdoor massage , the purpose of which is to remove blood clots accumulated in the uterus and restore the contractility of the muscles of the uterus. Massage is performed through the anterior abdominal wall.
Immediately after childbirth on the lower abdomen and perineum apply an ice pack . This is done to actively contract small blood vessels and stop bleeding. Keep ice no more than 20 minutes.
Empty your bladder as soon as possible after childbirth. This is done to prevent urological infections, bladder muscle imbalance due to overstretching and bleeding due to the fact that the enlarged bladder interferes with the normal contraction of the uterus after childbirth. To do this, immediately after childbirth, a woman is placed with a catheter.
Bed rest It is customary to observe in maternity hospitals during the first 6-8 hours after childbirth. You should not get up and walk before this time, even if you seem to be feeling well. Firstly, the female body has undergone a heavy load and needs to rest, and secondly, dizziness and even fainting are often observed during this period, associated with a sharp drop in blood pressure, which can lead to a fall and serious injury. In the maternity hospital, they may not even be allowed to go to the toilet - instead, you will have to use the ship. And if you are still allowed to go to the toilet, then you should not go there alone.
C-section - a special case. During the first days after the operation, the young mother is in a special postpartum ward (or intensive care unit) under constant supervision: she is corrected for blood loss, antibiotic therapy is started to prevent postoperative infectious complications, and intestinal function is stimulated.
The main symptoms that appear in the first few hours after childbirth
Chills, hunger and thirst.
A slight fever immediately after giving birth - possibly due to dehydration.
Great fatigue, especially if the birth was long or difficult.
Pain at the site of the stitch, and then numbness in this area, if you have had C-section (especially if it was the first) or after an episiotomy.
The first days after childbirth (postpartum ward)
Most often, the first look in the mirror is not pleasing - after giving birth, a young mother often looks like she has been in a fight - red eyes, on her face - numerous brown dots that look like moles. Pushing during a difficult second stage of labor can lead to rupture of blood vessels in and around the eyes , because of which the eyes turn red, and bruises may even appear around them. This is most likely if a woman holds her breath and at the peak of her efforts, her pressure in the vessels of the head rises sharply. What to do with such "beauty"?
Cold compresses on the eyes (for 10 minutes), which are done several times a day, will have a calming effect and speed up recovery, which will come in a maximum of 6-10 days. In about a week, the hemorrhages on the face will also pass.
Naturally, the consequences of childbirth are lochia - discharge of residual blood, mucus and tissue from the uterus. In the first three days after childbirth, they are usually as plentiful (and sometimes more plentiful) as during menstruation - their total volume can be about 300 ml. In the first days after childbirth, the main component of lochia is blood from vessels that have torn at the placenta attachment site, so the discharge is intensely red. Increased discharge when standing up and other movements is a normal process.
After childbirth, a woman may also be disturbed muscle pain in different parts of the body . Which muscles hurt the most depends on which particular group you strained the most during childbirth: pain can be concentrated in the chest, back, legs, and even shoulders. If the pain is indeed muscular in nature, it should gradually subside over the next few days. Heat (in the form of hot baths or heating pads) or pain medication may be recommended to reduce discomfort.
Cramping abdominal pain that gets worse during breastfeeding , are caused by normal postpartum contractions of the uterus, which is busy with important work: it compresses the blood vessels that broke during the separation of the placenta, and returns to the size it had before pregnancy. Postpartum painful contractions are experienced primarily by those women in whom the muscles of the uterus have been stretched significantly, which is more typical for repeated births and for the birth of twins. Many mothers who give birth to their first child do not even notice such pains. Painful contractions become especially noticeable during breastfeeding, because when sucking, the hormone oxytocin is released, which stimulates uterine contractions. Pain relievers will help at first, the pain usually goes away within two to seven days. If this doesn't happen, or if pain medication doesn't work, tell your doctor.
Pain in the perineum and the discomfort associated with it - and this feeling is also normal, because it is unrealistic to expect that a 3-3.5-kilogram child will pass through the perineum without any consequences. Even if during childbirth you avoided ruptures and you did not have an episiotomy (perineal incision), this area was still stretched, squeezed, i. e. was injured. The pain will go away in a few days.
In the case of an episiotomy, pain may increase, especially with laughter, coughing, sneezing, defecation. Like any wound, the episiotomy site will not heal immediately - it usually takes 7 to 10 days. At this time, the woman is forbidden to sit so that the seams do not come apart. At the same time, they are allowed to sit on the toilet and sit on a hard chair on the 5th day on that buttock where there is no seam.
While you are in the hospital, a nurse will check your stitches regularly for inflammation or other signs of infection. However, the occurrence of infection with good hygiene is unlikely. From the rules of hygiene, the following must be strictly observed: after each visit to the toilet, it is necessary to wash the perineum with warm water, it is possible without soap. Take a shower twice a day.
In the first time after childbirth, only colostrum is released from the breast - a thick yellowish liquid, and milk appears on the 2-3rd day. During the onset of lactation, the mammary glands often become hypersensitive, sometimes a bursting pain in the chest , she "stones". With significant breast engorgement, the doctor may recommend limiting the amount of fluid consumed, with excess milk and significant breast engorgement, you may need to pump. To prevent nipple cracks and when they appear, you will need BEPANTEN ointment.
During the first day after childbirth, many women experience difficulty urinating . Some simply do not have the urge to urinate; others feel the need but cannot empty their bladder. Someone else can urinate, but at the same time experiences pain and burning - these are signs of inflammation of the urethra, which must be reported to the doctor. Despite all the difficulties, it is necessary that the bladder be emptied in the first 6-8 hours after childbirth. This is done so that the enlarged bladder does not interfere with the normal contraction of the uterus after childbirth. As a last resort, if you still cannot empty your bladder within 4 hours after giving birth, a woman may have a catheter placed. After childbirth, it is necessary, regardless of desire, to urinate at least once every 4 hours. Bladder function returns to normal after 3-7 days.
Causes stool problems There may be several factors, both physical and psychological. Firstly, the abdominal muscles that are involved in defecation stretched during childbirth and began to work less efficiently. Secondly, the rectum, like the bladder, also experienced the pressure of the advancing fetus and cannot immediately establish normal work. In addition, it is relatively empty due to increased activity early in labor, reduced food intake, and possibly decreased appetite early in the postpartum period due to excitement or fatigue. More often, an obstacle to postpartum defecation is the fear that the seams will open. Getting your bowels back on track is rarely easy or quick, and takes a few days. Include more fiber in your daily diet - bran bread, fresh fruits and vegetables, dried fruits and nuts, boiled prunes - and increase your fluid intake. This will soften the stool, but make sure that there are no allergens among vegetables and fruits: remember that before the arrival of milk and the establishment of lactation, you should not drink a lot of liquid. Try to move more if your condition allows. And don't worry about your stitches coming apart - they won't. Since a woman is often given a cleansing enema before childbirth, there is usually no stool in the first 2-3 days.
To avoid dizziness , after childbirth, get out of bed carefully, calmly, do not rise abruptly. Especially this recommendation should be heeded by women with low blood pressure, those who have lost a lot of fluid during childbirth, who feel severe weakness. Sleeping and lying after childbirth is better on the stomach: in this position, the uterus contracts faster.
Postpartum the abdomen does not immediately return to its original shape , because his muscles and skin need time to contract, as well as the muscles of the uterus. In order to quickly return to its former shape, immediately after childbirth, after the first examination by the doctor, you can use a special postpartum bandage, as well as breathing exercises (traditional gymnastics can be performed only 6-8 weeks after childbirth). Breathing exercises - this is breathing with the stomach: on the inhale, inflate the belly, on the exhale - blow it off. Repeat 10-20 times, 4-5 times a day.
C-section: on the first day after the operation, it is only allowed to drink water with lemon juice. But already on the second day, the mother is transferred to the postpartum department, where she immediately begins to lead an active lifestyle - she gets up and walks, feeds her baby.
The main symptoms that may appear on the first day after childbirth:
Bloody vaginal discharge .
Painful contractions of the uterus after childbirth, even after a day.
Discomfort or pain in the perineum (especially if you have had stitches).
Discomfort when walking if you have had stitches.
Muscle pains all over the body.
Rupture of capillaries (in the eyes, on the face).
Difficulties with urination.
Difficult and uncomfortable bowel movements in the first few days; constipation.
First week after childbirth
ongoing vaginal discharge : within 1-2 weeks after delivery, the discharge gradually becomes watery pink, then brown and finally yellowish white. During this period, you should use sanitary pads (and not tampons: they can provoke inflammatory diseases of the uterus and appendages). Allocations may stop after two weeks, and may continue up to the 6-8th, and sometimes a small admixture of blood appears in them. With the resumption of bleeding, you should consult a doctor. If after the first week you experience something more serious than decreasing spotting, such as heavy spotting, or a foul-smelling discharge, or a fever, you should see a doctor - there may be a piece of placenta left on the uterine wall. In this case, hospitalization and possibly curettage of the uterus to remove the remnants of the placenta will be required. You should also see a doctor if brownish or yellowish lochia persists for more than 6 weeks, as this may be the result of an infection, especially if accompanied by fever or pain, and tenderness in the abdomen.
seams left after episiotomy must be kept dry and clean. Most likely, they will have to be processed even after discharge from the hospital, and when taking a shower, make sure that water does not enter the vagina. You can wash the external genitalia and perineum with a decoction of chamomile, calendula, eucalyptus. The first three months after childbirth, you will have to get out of bed carefully, first turning on your side, bypassing the sitting position (this will reduce pressure on the muscles of the perineum), and feed the baby lying on your side or half-sitting; weights cannot be lifted.
The birth of a child is a very significant event for a woman, not only physically, but also psychologically. Firstly, childbirth itself depletes a young mother, and secondly, hormone production changes during and after childbirth. Therefore, it is natural that at this time comes period of mental instability . The most typical feeling in the first days after childbirth is elation, but in the following days, and sometimes weeks, some women become sad, despondent, withdrawn and apathetic; often they suffer from feelings of guilt that they do not feel great excitement about the birth of a baby. It is worth noting that these are the usual postpartum emotions associated with the normalization of hormonal levels. The advice is to walk more, relax, focusing not on negative, but on positive emotions.
Within 7 days after the caesarean section (before removing the sutures), the nurse daily treats the postoperative suture with antiseptic solutions (for example, iodine, "brilliant green") and changes the bandage. The skin scar is formed approximately on the 7th day after the operation; already a week after the caesarean section, you can safely take a shower. Just do not rub the seam with a washcloth - this can be done in another week. Discharged from the maternity hospital in the absence of any complications on the 7-10th day after operative delivery. Since the pain in the scar area can persist for up to several weeks, it can be difficult for a woman to bend over, so it is easier to sit down, bending her legs at the knee and hip joints. When feeding, it is rational to use positions in which the baby does not lie on the stomach (does not put pressure on the scar area), for example, when the baby lies under the mother's arm.
Main symptoms in the first week after childbirth
Discomfort and swelling of the mammary glands between the second and fifth days after childbirth (sometimes later).
Excitation or depression.
Feelings of helplessness and fear at the thought of your role as a mother, about breastfeeding (if you are breastfeeding).