Placenta variations
Once the placenta and membranes are delivered your caregiver will examine them to determine whether they are healthy, have formed normally and make sure that the entire placenta and membranes have come away completely. This can be done in front of you if you wish to look at your placenta, or they may take it into another room to be done before disposing it, usually burned with other contaminated waste (if you do not wish to keep it). You can read more in the FAQ's for this section dealing with
placenta rituals.
The things your caregiver looks for are the placenta's size, shape and thickness - are these all normal? The texture, is it gritty and calcified - meaning overdue looking? Do any sections look like they were not functioning - darkened or infarcted because of no blood flow? Are all the mounds of placental tissue present (called cotyledons, resembling liver), meaning that the placenta is complete? Do the membranes look complete or are they ragged and torn and could some be missing (left behind in the uterus)? Are there 3 blood vessels in the cord - 2 arteries and 1 vein?
Any pieces of the afterbirth left in the uterus can possibly cause an infection, or occasionally excessive bleeding, in the days following the birth. If your caregiver notes that not all the placenta and/or membranes have come away, they will normally document it in your notes as the placenta being incomplete and/or the membranes being ragged, generally taking a wait and see approach. In most cases the uterus will expel the piece(s) of placenta or membrane on its own within hours or a few days after the birth. You may notice this by passing a large clot or seeing a fine piece of tissue come away.
If the woman's bleeding becomes heavy, and/or she starts to pass several large clots, an ultrasound may be performed to see if any part of the afterbirth can be seen left inside the uterus. If so, a curette or
D and C