In this article:
What is a Placenta?
During pregnancy, the placenta grows in your uterus. It’s like a temporary tissue that supplies oxygen and food to the foetus and removes waste through the umbilical cord. Your body naturally separates the placenta from the uterine wall, as it isn’t required post-delivery.
Delivering the placenta is the third stage of labour. The initial stage is when your cervix opens because of contractions. The second is when you push the baby out.
How Does the Placenta Come Out Naturally?
After your baby’s birth, your uterus keeps contracting. These contractions assist in detaching the placenta and moving it out through the vagina.
In hospitals, doctors often give a small dose of oxytocin (the same hormone that triggers contractions) to reduce bleeding and help the placenta come out faster. This process is known as the active management of the third phase.
In other instances, your care provider may wait for the placenta to come out naturally, which is called physiological management. Either way, the placenta usually comes out within 30 minutes after delivery.
What Does It Indicate When the Placenta Doesn’t Come Out?
A retained placenta is when it doesn't come out within 30 to 60 minutes. This indicates the partial or complete presence of the placenta inside.
There are three major types of retained placenta:
- A trapped placenta, which is released by the uterus but gets stuck behind the closed cervix
- An adherent placenta, which sticks more firmly than usual to the uterine lining and doesn't detach naturally
- A placenta accreta is a rare condition in which the placenta grows too deeply into the uterine wall and doesn't detach naturally
Why Does The Placenta Remain Inside Sometimes?
- Post-delivery, the uterus didn't contract strongly enough
- Parts of the placenta are still attached to the uterus
- The cervix closed before the placenta came out
- There was scarring from a previous surgery, such as a C-section
- Rarely, the placenta has grown deeply into the uterine lining
How Do Doctors Help Remove a Retained Placenta?
If the placenta doesn't come out naturally, your doctor or midwife will take a few careful steps.
The goal is always to provide you comfort while removing it safely.
Encouraging Natural Delivery First
You may be asked to try breastfeeding, gentle pushing, or nipple stimulation, all of which trigger oxytocin release and help the uterus contract. Sitting upright or changing positions can help gravity assist the process.Medication
If things don’t happen naturally, you might get an oxytocin shot to make your uterus contract harder. This usually loosens and releases the placenta.Manual Removal
Even if that doesn’t work, the doctor might gently remove the placenta out by hand. You’ll be under anaesthesia, so you won’t feel the pain.Surgery (rarely)
If the placenta is really stuck in there, surgery might be required for a safe removal.What to Expect During the Process?
If the placenta takes a while to come out, you can expect pelvic pressure or gentle contractions. You may also notice mild bleeding.Your medical team will closely monitor you during this time, such as checking your blood pressure, pulse, and bleeding.
Remember, you must ask questions or express your feelings. Your medical team is there to make you feel safe and comfortable.
Why Should the Placenta Be Eliminated?
A retained placenta needs to be removed faster. If it stays inside, you could get an infection or bleed heavily. Once detached, your uterus can contract appropriately, and bleeding will reduce.After treatment, most individuals recover very well. Within a few hours, your body starts to feel normal, and you can focus on recovery, rest, and bonding with your baby.
Can You Prevent a Retained Placenta?
You can't always prevent it, but you can reduce the risk:- Don’t pull the umbilical cord; let the doctor or midwife handle it
- After giving birth, breastfeed right away. This helps your body with oxytocin.
- Try to stay calm post-delivery, since anxiety can inhibit the process
- Go to all your prenatal appointments. Ultrasounds can spot issues like placenta accreta early on.
Not every delivery goes exactly as you planned, and that's perfectly fine. If your placenta doesn't come out naturally, it doesn't always indicate something is wrong; it just means your body needs additional support.
The modern medical care process safely and quickly removes a retained placenta. The best thing you can do is stay relaxed, trust your medical team, and remember that once the placenta is out, your body can fully begin the beautiful process of recovery.
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FAQs on What Happens When the Placenta Doesn’t Come Out Naturally
- How long does the placenta take to be released after delivery?
A natural delivery may take up to an hour, but in most cases, it’s between 5 and 30 minutes. - Would it be agonising if the placenta isn’t released automatically?
You might encounter gentle cramps, but doctors ensure your comfort. If manual removal is required, you’ll be provided with anaesthesia.