The umbilical cord serves as a vital connection during pregnancy, acting as the lifeline to her developing baby. It facilitates the transfer of oxygen and nutrients from the mother’s bloodstream to the fetus, while simultaneously removing waste products. Its connection to the baby’s navel and the mother’s placenta ensures continuous exchange.
The Placenta’s Journey After Birth
The delivery of the placenta marks the third stage of labor, beginning immediately after the baby is born. During this phase, the uterus continues to contract, helping the placenta detach from the uterine wall. These contractions are usually milder than labor contractions and may feel like strong menstrual cramps.
Signs that the placenta is separating include a gush of blood, a lengthening of the umbilical cord, and a change in the shape of the uterus. The placenta typically delivers within 5 to 30 minutes after the baby’s birth, though it can sometimes take up to an hour.
There are two primary approaches to managing this stage: physiological (natural) and active management. Physiological management involves allowing the placenta to deliver spontaneously without medical intervention, often encouraged by skin-to-skin contact and breastfeeding which stimulate natural contractions. Active management often involves administering a uterotonic medication, such as oxytocin, immediately after birth to encourage uterine contractions.
Active management may also include controlled cord traction, where gentle pulling on the umbilical cord aids in the placenta’s expulsion. This approach is frequently recommended due to its ability to reduce the risk of excessive bleeding after birth.
Immediate Maternal Recovery
Following the delivery of the placenta, the mother’s body begins an immediate recovery phase. The uterus continues to contract, a process known as afterpains, helping compress blood vessels where the placenta was attached. These contractions are important for minimizing blood loss and aiding the uterus in returning to its pre-pregnancy size.
Afterpains can feel like menstrual cramps and may be more noticeable, especially during breastfeeding, as the release of oxytocin during nursing stimulates uterine contractions. Vaginal discharge, called lochia, is also a normal part of postpartum recovery. Lochia consists of blood, mucus, and uterine tissue, and it changes in color and volume over several weeks.
Initially, lochia is bright or dark red and heavy, similar to a menstrual period, sometimes with small clots. Over the subsequent days to weeks, it typically transitions to a pinkish-brown, then a yellowish-white discharge, gradually becoming lighter. Medical staff will perform checks to monitor the mother’s blood pressure, pulse, and the firmness of her uterus to ensure stability and detect any unusual bleeding.
Understanding Potential Challenges
While the third stage of labor is usually straightforward, certain challenges can arise. One concern is a retained placenta, which occurs if part or all of the placenta remains in the uterus after delivery. This can happen if the uterus does not contract strongly enough, or if the placenta is too deeply attached. Retained placental tissue poses a risk for significant bleeding and infection because the uterus cannot properly contract to close off blood vessels.
Another challenge is postpartum hemorrhage (PPH), which involves excessive bleeding after birth. The most common cause of PPH is uterine atony, where the uterus fails to contract adequately after the placenta is delivered. Other causes can include trauma to the birth canal or issues with blood clotting. PPH requires prompt medical intervention, which may involve uterine massage, medications to stimulate contractions, or removal of any remaining placental tissue.
The Placenta’s Post-Delivery Fate
Once the placenta has been delivered, medical staff typically examine it thoroughly. This examination helps confirm that the placenta is complete and no fragments have been left inside the uterus. They inspect its size, shape, color, and the integrity of both its fetal and maternal surfaces, as well as the umbilical cord.
After examination, the placenta is usually disposed of as medical waste, often through incineration, following hospital protocols. However, parents may request to keep the placenta for cultural practices, burial, or other personal reasons. In such cases, the hospital will provide guidelines for safe handling and transport.
Cord blood banking is an option where blood remaining in the umbilical cord and placenta is collected and stored. This blood contains stem cells that can be used for potential medical treatments in the future. Some individuals also consider placenta encapsulation, though this practice is not medically regulated and involves processing the placenta for consumption.