Some women have the chance to expel their placenta naturally within minutes of delivery, others have to push to get it out. And some others may push, but the placenta, or a piece, will remain inside the uterus after the birth of the baby. This is called placental retention.
What are the causes of placental retention?
"We do not have a clear answer to that, scientifically," says Dr. Lucie Morin, Head of the Department of Obstetrics and Gynecology at CHU Sainte-Justine. The latter explains that sometimes the placenta invades the uterus, much like a tumor. "This is called placenta accreta". This pathology is the most serious cause of placental retention, but not the most common.
Beyond all this, any woman who gives birth can experience the retention of the placenta. But, good news: just because it happens once doesn't mean it will happen next time!
When the placenta does not want to come out
As a general rule, at the hospital, intravenous Syntocinon (a synthetic oxytocin) is immediately given to all patients after the expulsion of the baby. "It's done to make it easier to expel the placenta and prevent postpartum hemorrhage," says Dr. Morin. If you do not have an IV, this synthetic hormone will be given to you by injection.
In a birth house, generally, we will let time do its job. On the other hand, if the placenta does not come out naturally within 30 to 45 minutes after the baby's exit, you will also be entitled to these injections of Syntocinon.
If the placenta still does not want to come out, the doctor will try to pick it up with their hand or a tool. "If the patient does not have anesthesia, we will take her to the operating room to give her anesthesia and we will get the placenta out with our hand or with other tools" explains Dr. Morin. It is unpleasant, however, it is a fairly simple procedure that takes a short amount of time.