What happens if part of the placenta gets left behind?
The placenta is the organ that grows inside the uterus to bring nutrients and oxygen from the pregnant person to the fetus during pregnancy.
It looks sort of like a liver pancake. (Don’t let the above illustration fool you - it’s much darker red than that.)
When the baby is first born, it comes out of the vagina with the umbilical cord still attached. At the other end of that cord is the placenta. Even though the hard work of getting the baby out is over, the uterus keeps cramping down, eventually squeezing the placenta off the wall of the uterus so it can come out after the baby.
See, the placenta is attached to the wall of the uterus with blood vessels. When the placenta comes off, the uterus cramps down enough to close all those now-open vessels off and stop them from bleeding. Imagine the inside of the uterus as a sort of upside-down colander:
And each hole is a blood vessel that used to be connected to placenta. If the uterus just hangs out as-is, blood will just pour out of each of those holes until that person dies. If the whole colander (uterus) can cramp down and close off those holes (blood vessels), the bleeding will stop.
So here comes the tricky part. If a piece of placenta or even a blood clot or a piece of membrane is left behind inside the uterus, it can’t cramp all the way down, and therefore it can’t stop itself from bleeding.
Therefore, we do a horrible thing called the manual placenta removal, in which the provider inserts their entire hand inside the new parent’s uterus and pulls out everything that could possibly be in the way. It can be excruciating, and we do everything we possibly can to avoid it. Luckily, it’s rarely needed.
Sometimes a small piece of something can be left inside the uterus without the problem of excess bleeding, and that can cause infection. If you’ve recently given birth and you have pain in your pelvis and bad smelling discharge or blood coming from your vagina, call your provider ASAP.
I cannot get over how beautiful she is. It still hasn’t really hit me that we created this tiny, lovely little person. It’s just incredible 😍💜 More will follow at some point tomorrow, including pictures and hopefully a name if we’ve decided on one by then.
Have you had any experience with women who've been very uncomfortable with being exposed and on display, as you are during a gynaecological exam/when giving birth? I have extreme anxiety about having a doctor (even a female) examine me, particularly if penetration of fingers or instruments is involved. One of these days I might have to see a gynaecologist, and if I ever have kids, I'd want a natural birth, and obviously I'd be touched a lot during labor. Tips on how to overcome this, please?
For keeping yourself covered during a pelvic exam:
I suggest wearing comfortable stretchy clothes. If you’re comfortable wearing a dress or skirt, do so. That way you can keep all your clothes on while the provider can access the part of you they need to examine.
When you’re on the exam table, feel free to arrange the sheet over your lap as you need. I suggest covering both knees with it, and then pulling back the middle of the sheet/drape to hold above your pubic bone.
Consider using a mirror to watch what the provider is doing as they examine you. You can be involved even as you get the healthcare you need.
As far as labor and delivery go - most people stop caring. A lot is going on when you’re laboring and you end up with less and less brain space for worrying about how clothed you are. If you’re low risk and your insurance supports it, I strongly suggest delivering in a birth center or in your home to minimize the possibility that you’ll be exposed to people you’re not comfortable with.