What Is a Post-Birth Placental Exam? (2023)

For many parents, their newborn baby is the only thing they’re thinking about after giving birth, but there's reason to think about the placenta as well.

"Parents might often be distracted—for good reason—by the time the placenta comes out," says Ericka C. Gibson, MD, an OB/GYN and the physician program director for perinatal safety and quality for Kaiser Permanente in Atlanta, Georgia. “They want to bond with their baby and the placenta becomes very very secondary at that point.”

It’s understandable that you might not even think twice about the placenta that nourished your baby inside your body all those long months. Fortunately, your healthcare provider is paying attention to it—and there's an entire exam just for that one organ. Ahead, learn more about what a placental exam actually entails, why it's essential, and what medical professionals can learn from studying a placenta after birth.

What to Know About the Placenta

What Is a Placental Exam?

The placenta is an organ that grows inside your uterus when you become pregnant. It provides oxygen and nutrients to your growing baby via the umbilical cord. A typical placenta is about 22 cm in diameter, about 2 cm thick, and weighs about a pound.

Just as your baby has to come out at some point, so does the placenta. Usually, the placenta is delivered within 30 minutes after the baby is born, according to Dr. Gibson. That’s when it’s time for the post-birth placental exam.

A placental exam is essentially what it sounds like: your healthcare provider will peer closely at your placenta after you deliver it to make sure nothing’s amiss. By examining your placenta, your physician can make sure that nothing was left behind in your uterus that could cause complications. They will also note any abnormalities in the umbilical cord or at the umbilical cord insertion site within the placenta.

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Why Is a Placental Exam Important?

One of the most crucial things that your doctor is looking for during a placental exam is a complete placenta. You might not even realize if small amounts have been left behind in your uterus without an examination, notes Michael Tahery, MD, an OB/GYN and urogynecologist in Los Angeles and Glendale, California.

“Sometimes the placenta fragments, and if it does, that [excess] portion can lead to an increased risk of hemorrhage or lead to an increased risk of infection,” says Dr. Tahery.

If it does appear that some pieces of the placenta are still in the uterus, your healthcare provider may need to go in and remove any of that remaining placental tissue manually or possibly via a .

One potential culprit for missing pieces of placenta is a condition known as placenta accreta, a complication that arises when the placenta grows deeply into the uterine wall, so bits of the organ remain attached while the rest of the placenta is delivered. Placenta accreta, which occurs in about 1 in every 2500 pregnancies, can sometimes cause significant blood loss after delivery. Usually, surgery to remove the remainder of the placenta is necessary—and in some severe cases, a hysterectomy may also be required to remove the uterus and the rest of the placenta.

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What Doctors Look for During a Placental Exam

The placenta is a two-sided organ, and your doctor will check out both sides—the side that was attached to your uterus and the side that was facing your baby.

The Parent's Side of the Placenta

When it’s inside you, the placenta is connected to the top or side of your uterus. It tends to be a deep red color, with knobby or bumpy surface of the lobes, which are known as cotyledons.

Your doctor will examine this side of the placenta to make sure that there aren’t any abnormalities and that it’s not missing any pieces.

“It’s not something that happens often, but it happens frequently enough that it’s part of our routine examination,” explains Dr. Gibson.

The Baby’s Side of the Placenta

Next up, it’s time to look at the baby’s side of the placenta.

“We also look at the placental membranes, again trying to ensure no membranes were stuck inside the uterus,” says Erin Higgins, MD, an OB/GYN with the Cleveland Clinic.

They’ll check out the color and surface of the membranes, making sure there aren’t any nodules or lesions that look suspicious.

Then they’ll examine the umbilical cord. The umbilical cord tethers your baby to your placenta, so your healthcare provider will check the cord for the number of vessels, length, and any knots, cysts, or other abnormalities. A normal umbilical cord consists of three vessels: two arteries and a vein.

Your physician will also eyeball the spot where the cord was inserted into the placenta. There can be rare occurrences like a velamentous cord insertion, when the umbilical cord inserted itself into the amniotic membrane, rather than the middle of the placenta. Research suggests the insertion site can affect a baby’s birth weight, so this could be useful information if your baby has a lower-than-expected birth weight.

What Happens to the Placenta After the Exam?

Normally, the post-birth placental exam is a pretty short affair, according to Dr. Gibson. If the placenta checks out just fine, the physician will just discard the placenta—or offer if to you if you’ve expressed your wishes to see or keep it. But if something looks concerning, your healthcare provider won’t discard the placenta or pass it to you.

“An abnormal-appearing placenta or certain antepartum/intrapartum complications will prompt a physician to send the placenta to pathology for a microscopic exam,” says Dr. Higgins. In other words, if any complications happen prior to (antepartum) or during childbirth (intrapartum), your doctor may send your placenta to the pathology department for a more detailed inspection.

The pathologist will notify your doctor about the results of their examination of the placenta.

A Word From Verywell

Most of the time, nothing is abnormal with the placenta after childbirth. But the post-childbirth placental exam is still important, just in case. It doesn’t take very long, and you might not even realize it’s happening while you’re admiring your new baby. If you have any questions about your placenta, don't hesitate to have a conversation with your healthcare provider.

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7 Sources

Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Rathbun KM, Hildebrand JP. Placenta abnormalities. In:StatPearls. StatPearls Publishing; 2022.

  2. International Vasa Previa Foundation.Velamentous cord insertion.

  3. Perlman NC, Carusi DA. Retained placenta after vaginal delivery: risk factors and management. Int J Womens Health. 2019;11:527-534. doi: 10.2147/IJWH.S218933

  4. Brigham and Women’s Hospital. Placenta Accreta.

  5. Barker D, Osmond C, Grant S, et al. Maternal cotyledons at birth predict blood pressure in childhood. Placenta. 2013;34(8):672-675.doi: 10.1016/j.placenta.2013.04.019

  6. Bosselmann S, Mielke G. Sonographic assessment of the umbilical cord. Geburtshilfe Frauenheilkd. 2015;75(8):808-818. doi: 10.1055/s-0035-1557819

  7. Brouillet S, Dufour A, Prot F, et al. Influence of the umbilical cord insertion site on the optimal individual birth weight achievement. BioMed Research International. 2014;2014:e341251. https://doi.org/10.1155/2014/341251

What Is a Post-Birth Placental Exam? (1)

By Jennifer Larson
Jennifer Larson is a seasoned journalist who regularly writes about hard-hitting issues like Covid-19 and the nation's ongoing mental health crisis, as well as healthy lifestyle issues like nutrition and exercise. She has more than 20 years' of professional experience and hopes to log many more.

Originally written byRobin Elise Weiss, PhD, MPH

What Is a Post-Birth Placental Exam? (2)

Robin Elise Weiss, PhD, MPH

Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.

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What is a placental exam after birth? ›

Performed as soon as possible after birth, an examination of the placenta is a unique opportunity to explore and understand the intrauterine environment, and also provides a record of events that may be associated with adverse pregnancy outcomes.

What is the placenta examination? ›

The placental examination provides important information about the effect of maternal abnormalities on the placenta or the cause of preterm delivery, fetal growth restriction, or fetal neurodevelopmental damage. In this study, the frequency of placental pathologies of patients in a tertiary hospital was investigated.

Why is it important to inspect the placenta after an uncomplicated delivery 6? ›

The placenta should be examined for completeness because fragments left in the uterus can cause hemorrhage or infection later. If the placenta is incomplete, the uterine cavity should be explored manually. Some obstetricians routinely explore the uterus after each delivery.

What do midwives look for when they are checking the placenta? ›

When examining the placenta and membranes be systematic and use your senses to observe, feel and smell. Examine the umbilical cord, observe the insertion point, note the length, any true knots or formation of thrombi. Inspect the cut end of the cord to determine if two arteries and a vein are present, (Figure 31.4).

What are the indications for placenta examination? ›

These criteria include indications in which placental pathology has clinical relevance, such as pregnancy loss, maternal infection, suspected abruption, fetal growth restriction, preterm birth, nonreassuring fetal heart testing requiring urgent delivery, preeclampsia with severe features, or neonates with early ...

How long after birth does the placenta come out? ›

The placenta should be delivered within 30 to 60 minutes after having the baby. If it isn't delivered or doesn't come out in its entirety, this is called a “retained placenta.” There are many reasons the placenta may not fully deliver.

How do you keep your placenta after birth? ›

it needs to be taken home as soon as possible after the birth and stored in a cool place. It should be stored in a refrigerator that does not contain any food and buried within 48 to 72 hours. Another alternative is to keep the placenta in its container, on ice and in an esky, for no more than 48 hours prior to burial.

What are the two types of placental delivery? ›

There are two options for placenta delivery - active management and physiological management.

What happens if a piece of placenta is left inside? ›

Sometimes, a piece of the placenta is left behind in the uterus (womb). It's not common, but it can be serious. It can cause problems days or weeks after the birth. Retained placenta can lead to severe infection or life-threatening blood loss for the mother.

What are 3 signs the placenta is going to deliver? ›

Separation of the placenta from the uterine interface is hallmarked by three cardinal signs, including a gush of blood at the vagina, lengthening of the umbilical cord, and a globular shaped uterine fundus on palpation.[1] Spontaneous expulsion of the placenta typically takes between 5 to 30 minutes.[1] A delivery time ...

What are the three signs of placental separation after delivery? ›

Separation of the placenta from the uterine interface is hallmarked by three cardinal signs, including a gush of blood at the vagina, lengthening of the umbilical cord, and a globular shaped uterine fundus on palpation.


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