Understand the afterbirth

Dive into the essentials of afterbirth, including its components, significance, and cultural practices.

One of the aspects of childbirth that doesn't always get a lot of attention but is crucially important is the afterbirth.

The afterbirth might sound like an epilogue to the main event of childbirth, but it's actually a key player in the health and recovery of both mother and baby. It refers to the placenta and other materials that are delivered after the baby arrives. Understanding the afterbirth is important for all expecting parents, as it's an integral part of the childbirth process that impacts the well-being of the mother immediately after delivery.

What is the afterbirth?

When we talk about the afterbirth, we're referring to everything that comes out of the uterus after the baby is born. It's part of the birthing process that might not get as much attention as the arrival of a new baby, but it's equally important for the health and well-being of the mother. 

Let's break down what the afterbirth includes and the role each component plays during pregnancy.

The Placenta

The placenta is often the star of the afterbirth show. It's a unique organ that only develops during pregnancy, attaching itself to the wall of the uterus. The placenta is the lifeline between the mother and baby, facilitating the exchange of oxygen, nutrients, and waste products through the umbilical cord. It's a critical player in keeping the baby healthy and growing inside the womb.

Amniotic Sac and Membranes

Imagine a protective, fluid-filled balloon that surrounds the baby during pregnancy—that's the amniotic sac. It's filled with amniotic fluid, which provides a cushion and protects the baby from infections and injuries. The amniotic sac and its membranes are also part of the afterbirth, ensuring the baby had a safe environment to develop in.

Umbilical Cord

The umbilical cord might be the most recognized part of the afterbirth. This flexible tube is the baby's physical connection to the placenta, carrying oxygen and nutrients from the placenta to the baby and returning waste products. After the baby is born, the umbilical cord is cut, but the segment attached to the placenta is delivered as part of the afterbirth.

The third stage of labor

The third stage of labor begins immediately after the baby is born and ends with the delivery of the placenta and the afterbirth. Once the baby has made their entrance, the uterus continues to contract. These contractions are less intense than those experienced during the delivery of the baby but are vital in detaching the placenta from the uterine wall.

During this stage, the healthcare provider might encourage the mother to push gently one more time or might assist by gently pulling on the umbilical cord to help deliver the placenta. In some cases, medication is administered to help stimulate uterine contractions and prevent excessive bleeding. The entire process usually takes about 5 to 30 minutes but can last up to an hour.

Why the third stage is important

The third stage is crucial for several reasons. First, it ensures that the placenta and other parts of the afterbirth are completely expelled from the uterus. Leaving any remnants behind can lead to complications such as infection or excessive bleeding, known as postpartum hemorrhage.

Moreover, the contractions during this stage help close off the blood vessels on the uterine wall where the placenta was attached, significantly reducing the risk of bleeding. The uterus begins to return to its pre-pregnancy size, a process known as involution. This stage marks the body's transition from pregnancy to the recovery phase.

What to expect during the third stage of labor

For many women, the third stage of labor is a time of relief and bonding with their new baby. It's common for mothers to hold and even start breastfeeding their baby during this stage, which can also help stimulate contractions to expel the afterbirth.

Healthcare providers closely monitor both the mother and baby during this time, ensuring that the afterbirth is fully delivered and that the mother’s condition is stable. They will check to ensure that the uterus is contracting properly and that there is no excessive bleeding.

The importance of an afterbirth examination

Once the afterbirth is delivered, it might seem like its role in childbirth is over. However, there’s a critical step that follows: the examination of the afterbirth by healthcare providers. This examination is not merely a routine procedure; it holds significant importance for the health of the mother post-delivery. Let’s delve into why this step is crucial.

Why Examine the Afterbirth?

Completeness Check: The primary reason for examining the afterbirth is to ensure that the placenta and membranes have been fully expelled. Any remnants left inside the uterus can lead to serious complications, such as infection or postpartum hemorrhage. A complete afterbirth signifies that the uterus can now begin the healing process without the risk of these complications.

Health Assessment: The placenta and membranes can provide valuable insights into the health of the pregnancy and the baby. Abnormalities in the placenta, such as calcifications or unusual size, can indicate conditions that may have affected the baby’s development or the mother’s health. This examination allows healthcare providers to identify potential issues that may require further monitoring or intervention.

Future Pregnancy Planning: For some conditions, examination of the afterbirth can offer clues about potential risks in future pregnancies. For example, certain placental issues can recur in subsequent pregnancies. Understanding these risks can help healthcare providers offer better guidance and care in planning for future pregnancies.

What Are Healthcare Providers Looking For?

During the examination, healthcare providers carefully inspect the placenta, membranes, and umbilical cord. They are looking for several key factors:

  • Completeness: Ensuring that the entire placenta and membranes have been delivered.
  • Abnormalities: Identifying any unusual features in the placenta or membranes that could indicate health issues.
  • Signs of Infection: Looking for any indications of infection that could affect the mother’s postpartum recovery.
  • Cord Vessels: The number of vessels in the umbilical cord (usually three) is counted to check for developmental anomalies.

The Procedure

The examination of the afterbirth is typically performed soon after delivery. The healthcare provider will visually inspect and, in some cases, manually feel the placenta and membranes to assess their condition. This process is usually done in the labor room, and the findings are documented in the mother’s medical record.

What are the possible complications?

While the delivery of the afterbirth typically concludes the childbirth process, there are times when complications can arise, posing risks to the mother’s health. Understanding these potential complications is crucial for recognizing signs early and ensuring prompt treatment. Let's explore the main complications related to afterbirth and how they are managed.

Retained Placenta

A retained placenta occurs when all or part of the placenta or membranes remain in the uterus after childbirth. This condition can lead to severe bleeding and infection if not promptly addressed. 

There are three main types of retained placenta:

  • Placenta Adherens is the most common type, where the placenta is attached to the uterine wall but does not detach naturally.
  • Trapped Placenta occurs when placenta detaches but becomes trapped behind a partially closed cervix.
  • Placenta Accreta is a rare but serious condition in which the placenta invades the uterus's muscle, making detachment difficult.

Treatment may involve manual removal of the placenta, medication to encourage uterine contractions, or, in severe cases, surgical intervention. Prompt treatment is essential to prevent excessive bleeding and infection.

Postpartum Hemorrhage (PPH)

PPH is defined as losing 500ml or more of blood within the first 24 hours following childbirth. It’s one of the leading causes of maternal mortality worldwide. Retained placenta fragments can be a cause of PPH, as they prevent the uterus from contracting effectively to seal blood vessels.

Management of PPH includes medication to stimulate uterine contractions, manual removal of retained placenta fragments, and, in severe cases, surgical interventions such as uterine artery embolization or hysterectomy. Blood transfusions may also be necessary.


If placental tissue is not completely expelled, it can serve as a breeding ground for bacteria, leading to infection. Symptoms may include fever, foul-smelling vaginal discharge, and abdominal pain.

Treatment typically involves antibiotics to clear the infection and, if necessary, removal of any retained placental tissue.

Prevention and Monitoring

Preventing complications related to afterbirth begins with careful monitoring during the third stage of labor and the immediate postpartum period. Healthcare providers may use techniques to encourage the placenta's natural expulsion and carefully examine the afterbirth to ensure its completeness. Active management of the third stage of labor, including the administration of uterotonic drugs, is a widely recommended practice to prevent PPH.

The Role of Healthcare Providers

Healthcare providers play a crucial role in managing and preventing complications related to afterbirth. Their expertise allows for the early identification and treatment of issues such as retained placenta or PPH. Through vigilant monitoring and intervention, they ensure the health and safety of mothers during the critical postpartum period.

Care and Management After Delivery of Afterbirth

After the successful delivery of the afterbirth, the focus shifts to the mother's recovery and the well-being of both mother and baby. This period is crucial for monitoring health, promoting recovery, and establishing the early bonds between mother and child. Proper care and management during this time can significantly impact the mother’s physical recovery and emotional well-being. Here’s what’s involved in the care and management after the delivery of the afterbirth.

Immediate Postpartum Care for the Mother

Monitoring: Healthcare providers will closely monitor the mother for signs of excessive bleeding, infection, or other complications. Vital signs are checked regularly, and the uterus's firmness is assessed to ensure it is contracting back to its pre-pregnancy size.

Pain Management: Pain relief measures are provided to manage discomfort from labor, delivery, and any interventions like episiotomy or tearing. Options can include medication, ice packs, or warm compresses.

Physical Recovery: Guidance is given on how to care for the perineum, manage lochia (postpartum bleeding), and recognize signs of potential complications. Mothers are encouraged to rest as much as possible to aid the healing process.

Support for Breastfeeding: For mothers who choose to breastfeed, support and guidance from lactation consultants can be invaluable. This includes help with latching, managing feeding schedules, and addressing any breastfeeding challenges.

Monitoring for Complications

Even after discharge from the hospital, it’s important for new mothers to be aware of signs that may indicate complications, such as fever, excessive bleeding, or unusual pain. Early detection and treatment of issues can prevent more serious problems.

Importance of Rest and Emotional Support

The postpartum period can be an emotional rollercoaster. Physical recovery, hormonal changes, and the adjustment to caring for a newborn can be overwhelming.

Rest: New mothers are encouraged to take it easy and sleep when the baby sleeps. Household tasks and other responsibilities should take a back seat to recovery and bonding with the baby.

Emotional Support: Support from partners, family, friends, and healthcare professionals can make a significant difference in managing the emotional challenges of the postpartum period. Postpartum support groups or counseling may be beneficial for some mothers.

Cultural Practices and Beliefs Surrounding Afterbirth

Though a biological and medical aspect of childbirth, afterbirth carries a rich tapestry of cultural significance and practices around the world. These traditions reflect the diverse ways in which societies honor the process of childbirth and recognize the role of the placenta, umbilical cord, and amniotic sac. Exploring these practices offers a fascinating glimpse into the varied beliefs about life, birth, and the connection between the physical and spiritual worlds.

Placenta Rituals and Ceremonies

In many cultures, the placenta is considered much more than a biological organ. It's often seen as the baby's first companion, sibling, or guardian throughout pregnancy. This belief underpins various rituals:

Burial: In countries like New Zealand, among the Maori people, and in Bali, Indonesia, the placenta is buried in a special ceremony. This act is believed to connect the child to the land, their ancestors, and their cultural heritage. The burial site is often chosen carefully, with some believing it influences the child's future.

Naming and Blessing: Some cultures have rituals for naming or blessing the placenta. These ceremonies recognize the placenta's role in the baby's life and honor its departure from the child's physical world.

Umbilical Cord Practices

The umbilical cord also holds significant meaning in various traditions, with practices focusing on its disposal or preservation:

Preservation: In some traditions, the dried umbilical cord is kept as a talisman or keepsake, believed to protect the child or ensure their health and prosperity.

Symbolic Use: Parts of the umbilical cord or the cord stump might be used in rituals or kept in specific places to symbolize the child's connection to their family, community, or spiritual beliefs.

Amniotic Sac Beliefs

The amniotic sac, or 'waters', is often viewed with awe due to its role in protecting and nurturing the baby. In some cultures, the way it breaks or is disposed of can carry symbolic significance, reflecting beliefs about the child's temperament, future, or the protection from negative forces.

FAQs About Afterbirth

In this section, we'll address some of the most common questions and misconceptions about the afterbirth, providing clear, evidence-based answers to help demystify this important part of the childbirth process. Understanding these aspects can offer reassurance and knowledge to expectant parents and broaden the general awareness of the afterbirth's significance.

1. Is it necessary to examine the afterbirth?

Yes. Examining the afterbirth is crucial to ensure that it has been fully expelled and to check for any signs of abnormalities that could affect the mother's health. This examination helps to prevent complications such as postpartum hemorrhage and infection.

2. Can anything be done with the afterbirth after delivery?

The disposal or use of the afterbirth varies widely depending on cultural, personal, and medical practices. Some choose to bury the placenta as part of a cultural ritual, while others may opt for medical disposal. In some cultures, the afterbirth is considered to have health benefits and may be used in traditional medicines or ceremonies.

3. What happens if the afterbirth is not delivered completely?

If the afterbirth is not completely expelled, it can lead to complications such as retained placenta, infection, and excessive bleeding. Treatment may involve medication to stimulate uterine contractions or a manual or surgical procedure to remove the remaining tissue.

4. How long does it take for the afterbirth to be delivered?

The delivery of the afterbirth typically occurs within 5 to 30 minutes after the baby is born. However, it can take up to an hour. The process is natural and usually requires little intervention, but monitoring by healthcare providers is essential to ensure it proceeds safely.

5. Does delivering the afterbirth hurt?

The sensations experienced during the delivery of the afterbirth vary. While the contractions needed to expel the placenta are generally less intense than those during childbirth, some women may still find them uncomfortable. Pain management techniques and support from healthcare providers can help alleviate discomfort.

6. Are there any health benefits to keeping the umbilical cord attached until it falls off naturally?

The practice of delaying the clamping and cutting of the umbilical cord has been shown to have health benefits for the baby, including improved iron stores and better circulatory transition. The decision to wait until the cord stops pulsating before cutting it is often made based on medical advice and personal preference.

7. Can the afterbirth indicate the overall health of the pregnancy?

Yes. The placenta and membranes can provide valuable insights into the health of the pregnancy. Abnormalities in the afterbirth can indicate conditions that may have affected the baby's development or the mother's health, offering important information for postpartum care and future pregnancies.

The bottom line

The afterbirth is an integral part of the childbirth process, playing a crucial role in both the medical and cultural contexts of birth. By understanding the facts and dispelling myths about the afterbirth, expectant parents can feel more informed and prepared for the post-delivery phase. Whether considering the physiological significance or cultural practices, the afterbirth is a testament to the miraculous journey of bringing new life into the world.

Get neli in your inbox
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.