Checking the Placenta

Once a baby is born the midwife or doctor will carefully check the placenta to ensure that no part of the placenta or membranes have remained inside the uterus. If any part of the placenta or membranes has been retained in the uterus, it can cause a postpartum haemorrhage and/or infection. The process of checking the placenta should take place as soon as possible after birth.

checking the placenta

When a baby is born at full term (37 to 42 weeks) and the placenta is healthy, it will measure approximately 15 to 20 cm in diameter and will be around 2.0 to 2.5 cm thick.  A placenta weighs approximately 500 to 600 grams, which is approximately one sixth of the baby’s birth weight. The size and weight of the placenta can vary considerably depending on the baby’s ethnicity, whether there were any pregnancy problems and how much the baby weighed.

In the photo above you can see the baby’s side of the placenta. In a healthy placenta is should look shiny, grey and translucent so that you can see the colour of the underlying placental tissue.

checking the placenta

In the photos above and below you can see the midwife examining the baby’s side of the placenta to make sure that there are no obvious abnormalities. The midwife takes particular note of where the baby’s umbilical cord is inserted into the placenta. In this case the umbilical cord is inserted in the middle which is known as ‘central insertion’. Sometimes the cord is inserted on the side of the placenta which is known as a ‘battledore insertion’. Rarely the cord can be inserted into the membranes instead of the placenta which is called ‘velamentous insertion’.

checking the placenta

In the photo below the midwife has brought the membranes around to the front so you can see the membrane sac that the baby developed in. The midwife is providing an explanation to the baby’s mother about the placenta. 

checking the placenta

In the photo below the midwife is checking the membrane and is making sure that there are two membranes known as the amnion and chorion. The two membranes stick together and can be pealed apart. 

checking the placenta

The midwife has turned the placenta over in the photograph below and begins to examine the placenta to make sure that it is complete and that nothing has been left inside the mother. 

checking the placenta

The mother’s side of the placenta should be dark maroon in colour and should consist of around 20 cotyledons (separate lobes of placental tissue). This is the side that attaches to the wall of the uterus through which the baby receives nutrients and water and by which waste products are passed back into the mother’s blood stream. 

checking the placenta

The midwife continues with her thorough examination of the placenta, noting the appearance and feel of the placenta.  These photographs depict a healthy placenta. Sometimes however a placenta may have calcified areas that feel gritty to the touch or an area of the placenta may be white or grey in colour indicating that that there has been tissue death in that area of the placenta. Noting such anomalies can help the midwife or doctor in providing care for the baby. 

checking the placenta

The midwife is examining the cord in the photo below noting the length of the cord and if there are any knots or blood clots in the cord. At term, the typical umbilical cord is 55 to 60 cm in length, with a diameter of 2.0 to 2.5 cm. The cord vessels are suspended in Wharton's jelly. The normal cord contains two arteries and one vein. If you look closely in the photo below you can see two small vessels which are the arteries and one larger vein. 

checking the placenta

The one anomaly found when checking this placenta was that there was a true knot in the cord. To find out more visit this page discussing true knots of the umbilical cord

checking the placenta

Written 25th June 2015

Reference

Johnson, R. & Taylor, W., (2010). Skills for Midwifery Practice. London, England: Elsevier

Jane Palmer is a private practice midwife and international board certified lactation consultant. Through her company Pregnancy, Birth and Beyond Jane provides midwifery, childbirth education and lactation services. For over 22 years, Jane has supported women and their families from preconception to the year following birth. Registering as a midwife in 1997, Jane went on to become one of the first Medicare-eligible midwives in Australia. Jane currently provides midwifery care in collaboration with the group practice Midwives @ Sydney and Beyond, caring for women planning to give birth at home or in hospital. In March 2012 Jane opened the PBB Health Centre in North Parramatta where midwives, general practitioners and allied health professionals provide services to the local community.

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