Placentas, the only organ in the body that can grow (from nothing!) after the body is fully developed, and can then be expelled from the body after it has completed its task. Pretty freakin’ cool, right? Let’s look more into this super neat organ and how it plays a huge role in baby’s development.

What comes to mind when you hear the word “placenta”? Do you picture something gooey, or something solid? Do you imagine a cocoon of safety around your baby? Does it look like a sack in your mind, or can you not even imagine it at all?

First of all, let’s chat about what the placenta actually is and what it does. During pregnancy, the placenta plays a vital role in baby’s development. It is an ephemeral or “temporary” organ that grows and attaches itself to the uterine wall of the birthing person. The baby is connected to the placenta via the umbilical cord, and the placenta is responsible for providing baby with blood, oxygen, and nutrients and for removing wastes from the baby’s blood. If the baby was an electric car, the umbilical cord is the port (or plug) that connects to the charging outlet (the placenta) – in a very real way, a transfer of energy takes place here, much like charging an electric car, so this analogy is quite accurate. The placenta is made up of early cells from the baby and cells from the maternal uterine wall.

So, if the placenta is considered a temporary organ, how does it ‘come out’? Well, the only way for the placenta to come out is for the birthing person to birth it.

Birthing the Placenta, or the Third Stage of Labour

Yep, you got it right. A birthing person just spent hours and hours working their way up the mountain of birth and is finally rewarded with greeting their new baby, but it’s not quite time to relax and throw in the towel just yet. What comes next can sometimes be just as painful as birthing the baby – birthing the placenta.

The Third Stage of Labour, or placental expulsion, is the physiological separation of the placenta from the uterine wall. It is typically expelled from the body between 15-30 minutes following the birth of the baby. Often an injection of oxytocin will be given once the baby is born to help with speeding up the process of separating from the uterine wall.

Complications

Sometimes there can be complications with the placenta following the birth of the baby.

1. The uterus stops contracting. If the uterus stops contracting, then the placenta can have a difficult time separating from the uterine wall. In this case, an extra dose of oxytocin may need to be given to the birthing person, and IV fluids will likely need to be started at this time (if it has not been started already). The care provider may need to manually press on the uterus (right around the belly button) to encourage contractions to get the placenta to release.
2. Postpartum hemorrhage. It is typical for the birthing person to lose about 2 cups (475ml) of blood once the baby is born. Anything more than that is considered postpartum hemorrhage. This can cause the birthing person to experience symptoms of shock, such as rapid pulse, chills, sweating, or trembling. In many cases, the care provider will give Pitocin via IV or an intramuscular injection, massage the uterus to encourage contractions, or begin nursing the newborn right away to release oxytocin that will help the uterus contract. In rare cases where the bleeding is out of control, a blood transfusion may be necessary. Care providers will regularly check the birthing person’s blood pressure and temperature, feel the uterus to ensure it is contracting, and check their underwear or ‘post birth pad’ for blood clots to make sure the bleeding has returned to normal.
3. Retained placenta. Sometimes when the placenta is separating from the uterine wall, some pieces of it may be left behind on the uterus. In this case, these pieces can stop the uterus from contracting fully and cause excessive bleeding. The care provider may try manually removing the pieces from the uterus, use vigorous massage of the uterus, and give additional Pitocin to get the pieces to release. Sometimes the birthing person will need surgery to have the pieces removed from the uterus – if they are not removed, it can lead to severe complications including infection, the pooling or clotting of blood inside the uterus, and a dangerous drop in blood pressure. The birthing person will be closely monitored to ensure all fragments of the placenta have been removed.

Delayed Cord Clamping

Until recently, standard practice once the baby was born used to be to cut the cord right away – this was done for efficiency purposes of being able to separate baby from the birthing person to examine the baby in a newborn unit. It was also believed previously that cutting the cord right away prevented jaundice (this was later debunked with other research suggesting the odds of jaundice were not increased by late cord clamping). The following benefits for a newborn baby have been found in support of delayed cord clamping:
–baby continues to receive blood and oxygen from the placenta until the cord stops pulsating
–the placenta is likely to detach sooner because the amount of blood inside of it decreases as that blood goes to the baby
–baby’s iron levels can increase by as much as 45%
–premature babies are less likely to need blood transfusions

Placenta Encapsulation

Other mammals that give birth to their young will chew the umbilical cord to separate their newborn from the placenta and then will often eat the placenta afterwards. One of the main reason for this is to hide the birth of their young from predators. Although this is mostly common in other mammals, human placentophagy (or eating of the placenta) is becoming more popular around the world, but particularly in the United States.

The placenta can be eaten in a variety of ways (raw, cooked, dehydrated) but the most common is placenta encapsulation. A company that offers this service will use sanitary equipment to steam the placenta and then dehydrate it. Once it has been dehydrated it is then crushed into powder and poured into gel capsules. These capsules can then be ingested by the birthing person at their discretion.

There has not been a significant amount of research done to support claims of clinical benefits of placentophagy, but anecdotally birthing persons are noticing physical and psychological benefits such as a decrease in postpartum depression, an increase in milk supply, and an increase in energy levels after birth.

So, there you have it, everything you wanted to know about the placenta! It’s a pretty incredible thing, and once again, just another reason why the uterus is AMAZING!