Understanding the placenta

Oh hello beautiful! You must be here to learn about the not so talked about parts of birth, like the placenta scab, postpartum bleeding, and healing after birth. As you plan to navigate the transition into newborn care, it is helpful to approach your learning and healing process with patience and self-compassion.

Anatomy of the Uterus and Placenta:

Within your uterus, aka womb and where your baby develops, there are several layers: the endometrium, myometrium, and perimetrium. 

Nestled within, the placenta forms and acts as a bridge of nourishment between you and your baby.

Along with the pelvic floor, there are many ligaments that come into play to support your uterus in place. Ligaments you may hear of often are the broad, ovarian, cardinal, uterosacral, and round ligaments. Pain that can arise as your baby grows, below your uterus, is often connected to your round ligament supporting your uterus. Check out more information on the round ligament.

Formation, Attachment, and Detachment:

During pregnancy, the placenta forms within the uterus. The placenta begins forming shortly after fertilization when the fertilized egg implants itself into the uterine lining and is fully formed by about 12 weeks of pregnancy. Over the course of pregnancy, the placenta grows and develops, forming a connection with your bloodstream and your baby. The placenta serves as a lifeline between you and your baby, providing essential nutrients and oxygen to your growing baby while removing waste products. It attaches to the uterine wall through a network of blood vessels.

When the time comes for your baby to greet the world, the placenta detaches from the uterine wall and is birthed after your baby. This process is facilitated by contractions of the uterus (that middle layer - the myometrium) and typically comes within minutes to an hour after baby is born. Since the placenta has been attached to your uterus throughout your entire pregnancy, there is quite a bit of healing to do.

Understanding Postpartum Bleeding:

In the early days with your newborn, you will experience postpartum bleeding, known as lochia. The discharge is not just blood, but also mucus and uterine tissue as your body sheds that innermost lining (the endometrium) of your uterus to heal the wound from the placenta detaching from the uterus. Lochia typically lasts for a few weeks and gradually decreases in amount over time.

Normal vs. Abnormal Bleeding:

In this tender time, it's important to listen to your body. With the significant changes to your sleep cycle and energy to care for your baby, you are still healing from your body experiencing growing and birthing a whole human. 

Give yourself grace and give attention to your postpartum bleeding. 

While some bleeding is expected after childbirth, it's essential to distinguish between normal and abnormal bleeding. Normal postpartum bleeding flows and gradually decreases over time. Abnormal bleeding, on the other hand, may involve heavy bleeding, large clots, or a sudden increase in bleeding after it has started to decrease. If you are experiencing abnormal bleeding, it is a call for attention, a reminder to honor your body's needs. This would be a good time to reach out to a trusted care provider.

Placenta Scab After Late Miscarriage:

In the case of a late miscarriage, when pregnancy loss occurs after the first trimester, there may still be remnants of the placenta that need to be released from the uterus. The healing process after a late miscarriage may take longer than after a full-term birth, and medical guidance should be sought to ensure proper healing and management of any complications.

Healing of the Placenta Scab and Uterine Wound:

Following the delivery of the placenta, a scab forms at the site where it was attached to the uterine wall. This scab acts as a protective barrier as your body works to heal the underlying tissue. With time and proper care, the scab will naturally release, allowing the uterus to renew and regenerate itself. This says a lot about how resilient the uterus is.

Nurturing your Path to Healing:

As you navigate the postpartum period, prioritizing rest and self-care will support your body's recovery. Staying hydrated, sipping warm teas, nourishing with warm, wholesome foods, and listening to your body's cues for rest and relaxation will only be helpful. You can use heat and cool packs and other comfort measures to encourage restfulness when you can.

Rest and Taking it Easy After Birth:

Taking it easy after your birth is vital for allowing the body to heal properly. Overdoing it can cause excessive bleeding or delayed healing of the uterine wound. In the weeks following your birth, allow yourself the space to rest and recuperate. Your body has undergone a significant transformation, and it's essential to honor its need for restorative rest as you adjust to life with your newborn. Gift yourself relaxation where you can.

The Journey of Healing:

Remember, that healing takes time and patience. Try to embrace this period of transition with gentleness and compassion, knowing that each step you take brings you closer to full recovery. Postpartum recovery is a journey - this would be a good time to reach out to trusted resources like friends and family for help in many ways. You could kindly ask them to pick up groceries for you, to organize a meal chain, to sit with the baby so you can shower, be company when you are ready. The options are endless and unique to you. It may be nice to brainstorm before the baby comes to organize what you can plan for and be open to what may change as you learn more in postpartum.

Honoring the Placenta

Many people feel called to honoring the significant role the placenta has. This can include placenta encapsulation, planting the placenta under a tree, having ceremony, or a moment to say thank you before the placenta is discarded. If this is something you feel called to, it is recommended to do research before making a decision that you feel good about.

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Alright, that was a lot of information. It’s not the most fun part of having a baby, but it doesn't change its importance. Understanding the process of placenta formation, detachment, and postpartum healing can be really helpful to know the why for postpartum care. By recognizing normal bleeding patterns, promoting healing through rest and self-care, and seeking medical attention for any concerns, recovery after birth can be tended to and lovingly prioritized.

Written by Sarina Abraham, Doula at Sweet Willow Birth, www.sweetwillowbirth.com

Inner Circular Muscle Layers (Endometrium) -

Inner lining of your uterus. These thick muscles soften and thin at the cervix for your baby to easily move down, through, and out of your uterus. This is also the layer that sheds during your period.

Middle Muscle Layers (Myometrium) -

Interwoven muscles with your blood vessels to allow blood flow to give oxygen to your uterus, connecting the inner and outer layers to work together in labor.

Outer Longitudinal Muscle Fibers (Perimetrium) -

Outermost and strongest layer of your uterus. These muscles travel up and over your uterus, tightening to draw up your inner layers to help the cervix to thin and open gradually. The wavelike muscle bands shorten and flex to help your baby move down and helps protect and move smoothly with your pelvis.