How to Identify Retained Placenta After Childbirth

After giving birth, most women experience postpartum bleeding, also known as lochia, which is the body’s way of expelling the remaining tissue and blood from the uterus. This bleeding is typically heaviest in the first few days after delivery, gradually tapering off over the course of four to six weeks. While this is a normal part of the recovery process, there are some instances where postpartum bleeding may signal a more serious issue, such as retained placenta. In this Antenatals article, we’ll explore how to distinguish between normal postpartum bleeding and symptoms of retained placenta, while highlighting the importance of antenatal care for preventing complications.

What is Retained Placenta?

Retained placenta occurs when part or all of the placenta remains inside the uterus after childbirth. The placenta, which is vital during pregnancy for providing nutrients and oxygen to the baby, is typically expelled within 30 minutes of delivering the baby. However, in some cases, pieces of the placenta can become trapped in the uterus, leading to excessive bleeding, infection, and other health risks.

If you’re concerned about postpartum bleeding, it’s essential to understand the signs of retained placenta. Early identification can help prevent complications and support a smoother recovery.

Signs of Retained Placenta

One of the most common signs of retained placenta is heavy, prolonged postpartum bleeding. Here are a few symptoms to watch for:

Excessive Bleeding: While some bleeding is normal after birth, pay attention if it seems unusually heavy or continues for longer than expected. Soaking through a pad every hour or passing large clots may be a sign of a problem.

Prolonged or Recurrent Bleeding: Most women find their bleeding subsides after a few weeks. If you notice your lochia has stopped and then starts again with heavy flow or dark blood, it could be a sign of retained placenta.

Foul-Smelling Discharge: A strong, unpleasant smell accompanying your bleeding can be a sign of infection, which is often linked to retained placenta.

Pain and Cramping: While mild cramping is common postpartum, severe or persistent abdominal pain could indicate that there is retained tissue in the uterus.

Fever or Chills: If you experience flu-like symptoms, such as fever, chills, or general malaise, these can be warning signs of an infection caused by retained placenta.

If you experience any of these symptoms, it is crucial to seek medical attention right away, as retained placenta can lead to more serious complications, including haemorrhage and uterine infections.

The Role of Antenatal Care in Preventing Retained Placenta

Antenatal care plays a crucial role in ensuring a healthy pregnancy, and it also helps reduce the risk of postpartum complications such as retained placenta. By attending regular antenatal appointments, you’ll be closely monitored by healthcare professionals who can identify any potential issues that may increase the likelihood of retained placenta, such as an abnormally attached placenta.

During your antenatal care, your healthcare provider will assess factors such as:

Placenta Position: Antenatal scans will help identify any abnormalities in the position of the placenta, such as placenta previa or placenta accreta, which can increase the risk of retention.

Uterine Health: Your antenatal clinic will monitor the condition of your uterus, ensuring it is contracting properly during labour and is free of any issues that could hinder the expulsion of the placenta.

Pregnancy-Related Conditions: Conditions such as high blood pressure, preeclampsia, or gestational diabetes can increase the risk of complications during and after birth. By addressing these conditions through antenatal support, you can lower your risk of retained placenta.

Regular antenatal appointments also give you the opportunity to discuss your birth plan, ensuring that you are aware of the steps your medical team will take to minimise the risk of complications.

Antenatal Support and Recovery After Birth

After childbirth, attending follow-up appointments is as important as attending antenatal appointments. These visits allow your healthcare provider to assess your recovery, monitor any symptoms of retained placenta, and ensure you are healing properly. If retained placenta is suspected, your doctor may recommend an ultrasound to detect any remaining tissue.

In addition to medical care, engaging in postnatal activities like antenatal yoga or prenatal yoga can support your recovery. These gentle practices promote relaxation, reduce stress, and improve blood circulation, which is beneficial for overall postpartum recovery. Antenatal yoga is often recommended during pregnancy, but continuing with these practices after birth can enhance your mental and physical well-being.

Treatment Options for Retained Placenta

If your doctor confirms that you have retained placenta, there are several treatment options available, depending on the severity of the condition:

Manual Removal: In some cases, your healthcare provider may need to manually remove the retained placenta from the uterus. This procedure is often performed with anaesthesia to reduce discomfort.

Medication: Medication may be prescribed to help your uterus contract and expel the remaining placental tissue.

Surgery: In more severe cases, a surgical procedure known as dilation and curettage (D&C) may be necessary to remove the retained tissue from the uterus.

If an infection has developed due to retained placenta, you may also need antibiotics to clear the infection and prevent further complications.

Importance of Rest and Self-Care

Whether or not you experience complications such as retained placenta, it’s important to prioritise rest and recovery in the postpartum period. In the weeks following childbirth, your body undergoes significant changes, and taking care of yourself is essential for a smooth recovery. Here are a few tips for supporting your postpartum recovery:

Get Plenty of Rest: Your body needs time to heal, so don’t hesitate to ask for help with baby care and household tasks.

Stay Hydrated and Eat Well: Eating a balanced diet and staying hydrated will support your body’s healing process and give you the energy you need to care for your newborn.

Attend Follow-Up Appointments: Your postnatal check-ups are just as important as your antenatal appointments, so be sure to attend them to monitor your recovery and address any concerns.

Retained placenta is a serious postpartum complication that requires prompt medical attention. While postpartum bleeding is a natural part of the recovery process, it’s important to know the warning signs that may indicate a problem. By attending regular antenatal checkups, staying informed about your health, and seeking medical advice if needed, you can help ensure a smoother and safer postpartum recovery.