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Placental Birth – Process, Complications & Care

Placental birth is the third stage of labour, during which the placenta is expelled after the delivery of the baby. It is a natural conclusion to the birth process.

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Things worth knowing about "Placental birth"

Placental birth is the third stage of labour, during which the placenta is expelled after the delivery of the baby. It is a natural conclusion to the birth process.

What is Placental Birth?

Placental birth, also referred to as the afterbirth or the third stage of labour, is the final phase of the childbirth process. After the baby is born, the placenta – the organ that developed during pregnancy to supply the baby with nutrients and oxygen – separates from the uterine wall and is expelled from the body. This stage is medically significant, as complications such as severe bleeding can occur if the placenta is not expelled completely or in a timely manner.

How Placental Birth Works

Shortly after the baby is delivered, the uterus continues to contract. These contractions cause the placenta to detach from the uterine wall and move toward the vagina for expulsion. Common signs that the placenta has separated include a small gush of blood, a lengthening of the umbilical cord, and a change in the shape of the uterus.

Spontaneous placental delivery: The placenta is expelled naturally, without assistance, usually within 30 minutes of the birth of the baby.
Active management: To reduce the risk of heavy bleeding, a uterotonic medication (such as oxytocin) is often administered after the birth of the baby, helping to speed up placental delivery.
Controlled cord traction: Healthcare providers may gently pull on the umbilical cord while applying counter-pressure to the abdomen to assist with placental expulsion.

Timeline and Normal Progress

Placental birth typically takes between 5 and 30 minutes. If it takes longer than 30 to 60 minutes, the condition is referred to as a retained placenta, which requires medical intervention. After expulsion, the healthcare team carefully examines the placenta to confirm it is complete, as retained tissue can lead to infection or ongoing bleeding.

Possible Complications

Although placental birth is usually uncomplicated, the following complications may occur:

Postpartum haemorrhage (PPH): Severe bleeding after delivery, which is one of the leading causes of maternal mortality worldwide.
Placenta accreta: The placenta is abnormally attached too deeply into the uterine wall and cannot detach on its own.
Retained placenta: Parts of the placenta remain in the uterus and must be removed surgically or manually.
Uterine inversion: A rare but serious complication in which the uterus turns inside out.

Medical Supervision

Placental birth is always monitored by midwives and doctors. To prevent postpartum haemorrhage, the World Health Organization (WHO) recommends the administration of oxytocin immediately after the birth of the baby as part of active management of the third stage of labour. The expelled placenta is subsequently examined thoroughly to ensure it is intact.

The Placenta After Delivery

After delivery, the placenta may be given to the mother upon request. In some cultures and traditions, the placenta is buried or treated in a ritualistic manner. Placentophagy (eating the placenta) is practised by some individuals; however, it is not medically recommended, as there is no proven benefit and potential health risks exist.

References

World Health Organization (WHO): Recommendations for the prevention and treatment of postpartum haemorrhage. Geneva: WHO Press, 2012.
Begley CM et al. – Active versus expectant management for women in the third stage of labour. Cochrane Database of Systematic Reviews, 2019.
Cunningham FG et al.: Williams Obstetrics. 25th edition. McGraw-Hill Education, 2018.

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