Retained some membranes after placenta delivered-questions

[itsybistyspider]

This happened in April and went to the ER after 2+ hours. Now looking for answers for the NEXT birth

Retained some membranes after placenta delivered- it would not budge with firm pulling/pushing after more then 2 hours. A ~6inch piece was removed with a long tweezer in the ER. 

can you tell me am I more likely to have this happen again?

What is the cause (OB said cervix closed to quickly?)?

How can I prevent it in the future?

How to manage at a UC?

Transfer to ER or wait? Trim off placenta or leave intact? 

[BlessedJess]

I guess it depends. I retained membranes for 4+ weeks. I don't really remember if it was week 4 or 6 when I finally expelled it. But it wasn't blocking blood flow or anything. I am not really sure how I did it, but it happened. Sometimes, though, an ER visit is needed to pull something out of the way if it won't come out on its own, particularly if excess blood loss is suspected. I didn't have any such problems, nor did I feel it up there, stuck. I just noticed it was missing from the placenta and noticed it when it came out weeks later. No infections or scary outcomes, no D&C either.
 

[phathui5]

You could have angelica tincture on hand next time:

http://www.birthingnaturally.net/cn/natural/angelica.html

http://i.herblore.com/overviews/placenta-release-tincture

[itsybistyspider]

yes- we did the placenta out tincture- but my cervix was "closed" tight around the membrane. good thought though

[Banana731]

This happened to me after my UC and my MW at the next birth said that it may have been from letting the placenta "drop" after I birthed it. And wouldn't you know, in that birth there it was, placenta hanging out but membranes still in. She just held the placenta up close to my body for me until they released. There may have been some twisting to help coax the membrane out, I think it was a bit stuck again. But it was whole this time with the extra care paid to it.


When I did have the membrane retained with the prior birth, after a day or so ( and some sage advice from MDC) I just worked up the courage to go over the toilet and get a firm grip in it and twist twist twist, then I stood up and twisted and pulled gently and it came right out. When I had just gently tried to pull when on the toilet before, it seemed really stuck. It was the twisting/standing thing that was key. It was a fairly large piece. Once it came out my cervix started closing down again and my cramping increased a bit for the rest of the day, so it wasn't quite finished, the membrane was blocking it.

[queenrilly]

well it's safe to have it retain unless you get a fever and cramping or hemorrage. I can't remember the actual timeframe, but I think its like 3 days normally for the entire WHOLE placenta to be safely delievered. as long as there is no fever or cramping, signs of distress, blood-loss etc, pay close attention to what your body tells you and how you feel ie sick or feverish, abnormally tired, etc. Also, immediately hold baby skin to skin and nurse directly after he/she comes out, this tells your body to let go of the placenta and causes afterbirth contractions, and contractions are what opens your cervix. Google!!!! Learn all you can about EVERYTHING pregnancy and birth related before baby comes so you're ready for anything!

and NEVER EVER PULL ON THE CORD, PLACENTA, let anyone else do it, or let anyone put there hands up there to try to loosen/pull pieces out!!!  you can massage and push on the uterus, as shown in various educational childbirth books and even gregory white's emergency childbirth handbook, but NEVER pull on the cord. it causes retention and hemorrage. thats actually usually the reason women who go to hospitals after hemorraging after birth because the doctor pulled on it or stuck his/her hand up there and fished around for pieces.
It happened to my aunt, they caused her to hemorrage by pulling the placenta out, then they soaked it up with cotton/gauze, and left pieces of that inside, then she got infected and died. So, when I had my first, my dad was very adament about not letting them up there at all.

Probably nothing new since you've UC'd before, but refreshers are always good, and there's always new information out there about everything under the sun.

Are you seeing an OB this time for prenatal? Do they think you'll retain again?

HTH!!! So scary that it retained! I hope everything goes perfectly when you do give birth and you were worried for nothing :) HUGS!

With my first that would have scared me to death because I was so uneducated about the process, my first was a hospital birth, so naturally I was forced to hopethe hospital knew everything. Then I bled for the next 2 months and was told it's normal everytime I called freaked about it never stopping. Now I read about UC moms everyday who only bleed for a week or two. Hmph. They pulled my cord, pushed my stomach, stole my placenta, and told me bleeding for 2 months is NORMAL. hmph I say! The best thing I've learned is that it's my body and I have rights and instincts that shouldn't go unnoticed, and I shouldn't be scared into worrying that the body can't do everything on it's own.

[phathui5]

"but I think its like 3 days normally for the entire WHOLE placenta to be safely delievered."

Can you provide a source for that? My experience/understanding is that the placenta generally comes out intact. I've had five children and attended 52 births and every placenta I've seen has been the whole thing and they've all been birthed within two hours of the baby.

[itsybistyspider]

yes- i also thought that the placenta comes out intact or else you need some "help" (whatever that means- herbs,drugs,D&C, depending...) since the placenta is vascular in a way the membranes are not. 

I did NOT retain placenta. I retained a piece of membrane that was about 4-6inches long. The placenta delivered whole in minutes.

thanks for all these ideas/suggestions. 

[queenrilly]

I don't remember where I found it. I was googling around because it was a topic in my uc group a while back. Google really is your best friend these days since no one remembers how birth is supposed to go. I think it was a UK site though if that helps narrow the results from google down. It was about how we went from 3 days to 30 minutes to 5 minutes when "allowing" mother to birth afterbirth naturally.


What other membranes are you talking about? Like a piece of the bag?

I'm a firm believer that the body knows more than our modernly brainwashed minds when it comes to things like birth. I wouldn't worry unless I started getting sick/fever (signs of infection) or I was bleeding a lot.
I would be worried about whatever those people pulled out on the other hand.

Some people keep losing pieces and globs in the 2-6 weeks they bleed after birth. Maybe that's the part that you had retained?

[Banana731]

There are two membranes. The inner amnion, which contains the baby and the amniotic fluid and the outer chorion which is amnion is in, and is part of the placenta
http://en.m.wikipedia.org/wiki/Amniotic_sac

If you have an attendant at your birth they will check to see the the membranes are more or less intact (they have to have at least opened) and that all the peices are there. This is done when they check to see that the placenta is intact. They can can shred sometimes and little pieces will be left in the uterus, a chunk can get ripped off and left behind if the membranes are trailing behind the placenta when you birth it, if you aren't supporting it's weight. I think shredding can occur sometimes in a fast birth (maybe phat can confirm that?) and that the side of the placenta that comes out first has to do with trailing membranes.

Small shredded pieces should theoretically be able to come out on their own, but your cervix wants to be closed and that can make expelling a larger piece difficult. when you have 4-6 in piece of something that feels like chicken skin hanging out your vagina and stuck in your cervix, you are quite aware of the fact that it does NOT belong there, and had I known to inspect the membranes thoroughly as well as the placenta, I may have at least been more mentally ready for that to occur.

When I did remove the membrane after a day and a half it was fowl smelling, and yellowed, because like all dead tissue it was rotting. I have difficulty believing that it would be okay for a placenta, unattached from it's blood supply and decomposing, to remain inside your body for 3 days. Not to mention that if your uterus can't shrink down properly and close off the blood vessels that have been supplying the placenta, you're going to loose too much blood.

Don't get me wrong, google can help you learn Calculus, but it can also tell you that the earth is a flat disc surrounded wall of ice. You still need check that your information is coming from reputable sources. Those of us who support free birth have enough difficulty already, it's best to make sure that the information we are putting out there into the world is sound.

[queenrilly]

Its not like Google had the actual article, it was a midwives article from the UK.

So if its hanging out of your vag pull it out yourself. I don't see it as a big deal. But I'm not an "Omg what is that, gross I need a doctor!" Kind of person. I don't believe the cervix is a steel trap after birth, on the contrary, it's most playable in that timeframe and breastfeeding even helps keep it open after birth, even 2 hrs, the body isn't stupid it's going to know something is there that should be let out. I don't think a fast birth has much to do with it because I'm prone to very quick births had haven't a problem. Maybe it was actual pushing instead of letting the body do its job, that I cannot attest for as I have only had physiological births. Letting my body plush instead of actively 'pushing', but I could see how that could cause the retention as it can cause tearing of the placenta and membranes both.

Not appreciating the personal attack Banana. If this were BBC you would have been reported and deleted before I ever saw this 'reply'.

[Banana731]

I don't feel that suggesting the use valid Internet sources, if you plan to share information, is a personal attack...

[phathui5]

"Some people keep losing pieces and globs in the 2-6 weeks they bleed after birth. Maybe that's the part that you had retained?"

Those globs are blood clots, not pieces of placenta.

The placenta is an organ that looks like this: 

When it comes out, the whole thing needs to come out.

[Stayathomemommy]

This thread has actually been reallyl helpful!!  My last homebirth after i birthed my placenta (which i am sure i just let drop into the toilet!) i thought i was done.  my midwife checked and it appeared intact.  a few days later this fleshy piece of membrane appeared while i was going to the bathroom.  freaked me out!!  called my midwife and she said i could give it a pull to see if it would come out.  I was so worried it was attached to my uterus or something like that!  it took quite a bit of me moving and lightly tugging.  i was getting light headed because i was so worried.  but when it released all was fine and i was so relieved.  midwife thought it was strange because she had checked and thought everything had been delivered but didnt say anything about next time holding the placenta instead of letting it just fall out.  i will keep that in mind for the next one.  when you are done you just want to be done and not have to deal with things hanging out or having to pull anything out!!

Thanks for your posts