What Is a Retained Placenta?

A retained placenta is a relatively rare complication that can occur during the third stage of labor where the placenta is retained inside the body instead of being delivered.
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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 13 August 2014
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A retained placenta is a relatively rare complication that can occur during the third stage of labor where the placenta is retained inside the body instead of being delivered. In one to every 100 or 200 births, the placenta is not delivered as expected and medical intervention is required to remove it. Retained placenta can be dangerous but is usually caught in time by alert midwives, doctors, and nurses.

The third stage of labor lasts from the delivery of the newborn to the expulsion of the placenta, also known as the afterbirth. Most women deliver the placenta within an hour of delivering the baby and in some cases, it may follow mere minutes after the birth. When it is not delivered naturally, medications can be used to stimulate uterine contractions to push it out, women can be massaged to encourage contractions, or the placenta can be removed manually by a care provider.

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There are a number of reasons for this complication to occur. One is uterine atony, where the uterus goes slack after delivery instead of contracting to push out the placenta. Another reason is a trapped placenta, where the placenta gets stuck behind the cervix, an especially common problem if the umbilical cord is pulled out of the placenta. Placenta accreta, where part of the placenta is deeply embedded in the uterine wall, can be another reason for a woman to have a retained placenta. Women who have experienced this complication in prior labors are likely to develop a retained placenta again, as well.

Sometimes the entire placenta is left inside the uterus and in other cases, only part is delivered. The risks or a retained placenta are twofold. In the first place, the woman can bleed, sometimes very heavily, because the uterus is not contracting and returning to normal size. Secondarily, women are at risk of uterine infections caused by the breakdown of the placental material left inside the uterus.

The signs of a retained placenta are usually evident to a care provider. Depending on a woman's birth plan, the interventions recommended or offered may vary. Women undergoing managed labor may be given medications to stimulate contractions and expel the placenta, for example, while women seeking natural birth might be encouraged to breastfeed immediately, as this sometimes triggers contractions, or to take herbal preparations. If the placenta cannot be delivered after these minimally invasive interventions, a midwife or doctor will need to enter the uterus to take it out.

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Discuss this Article

turquoise
Post 3

Sometimes a retained placenta happens after delivery by chance, when some of the placenta passes out and some remains. It happened to my sister and the doctors didn't notice it. She was hospitalized for an infection one week after giving birth. That's when they found the remaining placenta and removed it. And she had to take IV antibiotics. It was kind of traumatizing for her because she wanted to be with her newborn and not at the hospital.

I've even heard that sometimes this can happen with a c-section, the doctor can miss a part of the placenta.

These are all rare incidents though. Thankfully, it doesn't happen to most people.

SarahGen
Post 2

@MikeMason-- Was your placenta trapped behind the cervix or was it attached to the uterine wall?

I think it's harder to get the placenta out when it's attached to the uterine right?

stoneMason
Post 1

I had a retained placenta after birth with my first child. It was quite bad. I was given medication for contractions but when that didn't work, I had to have the placenta manually removed three hours after giving birth. I lost some blood in the process.

I'm pregnant with my second child now and I have a new doctor. I've told her about the retained placenta with my first child. She told me that I will probably be fine, but they will take precautions (have a IV drip, etc), in case I experience this again. I'm trying not to worry about it because I have a friend who had retained placenta with her first pregnancy but she didn't have it with her second. I'm hoping that this will be the case with me.

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