Chapter 13: The birth of the placenta – stage 3 of labor
You can see the membranes best on the top of the placenta.
They will be broken open, but check to see if they are all there.
Bottom of the placenta
The bottom of the placenta (the side that was attached
to the womb wall) has many lumps. Sometimes the
bottom of the placenta will have hard white spots or
dark patches. This is not dangerous. To check this
side, cup your hands and hold the placenta
so that all the lumps fit together. Look for a
hole or a rough edge where a piece might
be missing. This piece may still be inside
Carefully look at every placenta after
every birth just as you would carefully look at
every baby. In this way, you will learn what is normal,
and be able to quickly recognize when something is not normal.
If you look carefully at the end of the cord, you should see 3 holes — 1 large hole
and 2 small holes. These are the arteries and the vein
(or vessels) that carried the baby’s blood to and from
Some cords have only 2 vessels, and some babies
with 2-vessel cords have problems later on. A doctor
should check these babies.
A piece of placenta is left inside the womb
If a piece of the placenta or membranes is missing, it may still be in the womb.
Help the mother push the piece out by having the baby breastfeed or by
massaging her nipples as if you were removing milk by hand (see page 285). If the
woman is bleeding, give oxytocin or misoprostol (see page 228).
If the piece does not come out, get medical help.
A Book for Midwives (2010)