What You Need To Know About Retained Placenta

After my first pregnancy, I had a lot of complications. Walking as little as five feet was unreasonably painful. My milk had come in within the first few days, but my supply was low. And my uterus and private areas were in an immense amount of pain. I expected motherhood to be hard, but no one had prepared for me just how hard this transition would be.

As a first-time mother, I wasn’t sure if what I experienced was normal — like medical practitioners insisted — or if I should trust my intuition. In the end, I listened to myself and my mother. And it’s a good thing that I did. Something wasn’t right about the way my body was healing after giving birth.

As it turned out, I was suffering from retained placenta — a painful and potentially life-threatening condition that limited my ability to be mentally present and physically recover during my first weeks of motherhood.

What Is Retained Placenta? And Why Does It Happen?

Under normal conditions, labor happens in three (general) stages:

1. The uterus starts contracting to prep for the baby.

2. A baby is delivered.

3. The placenta is expelled.

However, in roughly 2% of cases, the third phase has challenges. When the placenta can’t be delivered naturally, a rare (but rising according to the American College of Obstetricians and Gynecologists) and life-threatening condition of retained placenta can occur.

Any time the placenta (in whole or in part) has not been delivered within 30 minutes of the baby’s birth, it falls under the umbrella of “retained.” But for some people, like me, it can take days (or even weeks) to find out that something is wrong.

There is a wide range of causes for this condition, but there are three retained placenta classifications:

The most common types of retained placenta is Placenta Adherents, which is when 30 minutes post-birth, the placenta still hasn’t separated from the uterus.

When the placenta separates but doesn’t leave the uterus, it is called Trapped Placenta.

The most dangerous type of retained is Placenta Accreta. With this third classification, the placenta has grown deeper than intended into the uterus which presents challenges with detachment. In the more severe occurrences, placenta accreta can create a need for blood transfusions, postpartum hemorrhage, and hysterectomies.

Risk Factors

There isn’t much (if anything ) you can do to prevent retained placenta, which makes it all the more important that you are thoroughly checked by a doctor immediately after labor as well as during your postpartum check-ups.

There are a few factors that increase the likelihood you will experience retained placenta:

– Being pregnant over the age of 30

– Delivery before the 34th week of pregnancy

– Long first and second stages of labor

– A prior experience of retained placenta

– Previous dilation and curettage (D&C) procedure

Having had a retained placenta with my first pregnancy, I’ve let my prenatal care specialist know that I am at risk for a repeat experience. By telling your medical team about your past birth experiences, you might be able to catch certain conditions early. Retained placenta can get really serious really face. The importance of communication with your care providers cannot be overstated. If you wait too long to be treated, you can be left with life-threatening consequences.

Signs And Symptoms

If I knew about retained placenta during my first birth, I would have interpreted my placenta coming out in pieces as a red flag. Unforuntaley, I didn’t, and my attending physician missed the signs.

Over the next few weeks, fatigue, discharge, and clots became my new normal. But again, emergency room doctors and calls to the nurse line told me those were all routine post-birth occurrences.

My lack of knowledge around the condition paired with a non-proactive medical staff led to it taking well over a month to receive a diagnosis.

The best way to improve your prognosis if you are battling this condition is look out for the signs and remove the remanents of the placenta as soon as possible. Symptoms range from person to person, but some of the most common signs include:

– Strong smelling discharge

– Recurrent pain

– Heavy bleeding

– Blood clots

– Fatigue

– In some cases, having retained placenta can even lead to issues with milk production.

It’s true, many of these symptoms sound like the typical postpartum healing process, but it’s crucial that you trust your body. If you are in a great deal of pain or something just doesn’t feel right, keep going to the doctor. It’s better to go and not need help than to need help and not go.

Treatment for retained placenta depends on how soon it is discovered. During the early stages, it can be removed by hand — however, this increases the chance of infection. Medications and breastfeeding can also be used to cause uterine contractions and help expel the placenta in the early stages. The longer it’s been, the more likely it is that you will require more invasive assistance.

In my case, anesthesia and an emergency D&C was required to remove the leftover remnants of the placenta. Thank goodness I was visiting my family when I was diagnosed. Otherwise, it would have been impossible to manage new motherhood and post-surgery healing with a breastfeeding newborn.

Retained placenta is both serious and painful. It’s essential that we discuss this and other postpartum conditions before they are experienced first hand. I don’t want women to find out the hard way, like I did. Awareness could easily be the first step to a life-saving intervention.