The placenta is a temporary organ that develops in the uterus during pregnancy, connecting the pregnant individual to the growing fetus. It begins to form shortly after a fertilized egg implants into the uterine wall, typically around seven to ten days after conception. The placenta continues to grow throughout pregnancy, adapting to the increasing needs of the developing baby.
What is the Placenta?
The placenta performs multiple functions during pregnancy. It facilitates the transfer of oxygen and nutrients from the pregnant individual’s bloodstream to the baby. Simultaneously, it removes waste products, such as carbon dioxide, urea, uric acid, and creatinine, from the baby’s blood, transferring them back to the maternal circulation for excretion. The placenta is also an endocrine organ, producing hormones like estrogen and human placental lactogen (hPL) that maintain the pregnancy and support fetal growth. It serves as a selective barrier, regulating what passes between the maternal and fetal circulations.
The Third Stage of Labor
The placenta does not come out with the baby; instead, it is delivered after the baby is born. This period is known as the “third stage of labor” and begins immediately after the birth of the baby, concluding with the expulsion of the placenta and its membranes. The delivery of the placenta is a distinct part of the birthing process. Typically, its spontaneous expulsion occurs within 5 to 30 minutes after the baby’s arrival.
During this stage, the uterus continues to contract, though these contractions are usually less intense than those experienced during the birth of the baby. These contractions help the placenta separate from the uterine wall. Signs of separation include a gush of blood from the vagina, a lengthening of the umbilical cord outside the body, and a change in the uterus’s shape, which may become firmer and more globular.
The delivery of the placenta can occur either physiologically or with active management. Physiological management involves allowing the placenta to expel naturally without medical intervention, often encouraged by skin-to-skin contact and breastfeeding that stimulate natural oxytocin release. Active management, commonly offered to reduce the risk of excessive bleeding, involves an injection of oxytocin to promote stronger uterine contractions and controlled cord traction to guide the placenta out. If the baby was born via C-section, the healthcare provider manually removes the placenta during the procedure.
Important Considerations for Placental Delivery
After the placenta is delivered, medical staff examine it to ensure it is complete and no parts have been left behind in the uterus. This includes checking the maternal surface for all cotyledons and inspecting the membranes for completeness. Retained placental tissue can lead to complications such as postpartum hemorrhage and infection. If parts are retained, further intervention may be necessary to remove them.
Following delivery, options for the placenta vary. In most medical settings, the placenta is treated as medical waste and disposed of by the hospital. Some individuals choose to keep their placenta for cultural, spiritual, or personal reasons, with practices ranging from burial to encapsulation. Cord blood banking, which involves collecting blood from the umbilical cord and placenta after birth, is another option, allowing for the storage of stem cells for future medical treatments. Medical supervision during and after placental delivery ensures the safety and well-being of the birthing parent.