What is the afterbirth?
The afterbirth is on the one hand the third and last phase of the natural process of birth, on the other hand it means the components of the amniotic cavity that are expelled in the course of the mentioned afterbirth phase. After the opening and subsequent expulsion phase, the afterbirth phase follows. This begins with the birth of the child and describes the period until the placenta is completely born.
The expulsion is caused by afterbirth contractions. In addition to the placenta, the umbilical cord, umbilical vessels and egg skins are further components of the afterbirth. In some cases, the afterbirth also contains a second placenta.
When does the afterbirth follow?
The afterbirth phase follows the delivery of the child and usually lasts up to thirty minutes on average. This means that about half an hour elapses between the vaginal delivery of the child and the complete expulsion of the afterbirth, i.e. the placenta, the umbilical cord and the egg skins. However, there are factors that can accelerate or delay the process.
If the afterbirth is not yet complete after about thirty minutes and there is increased bleeding, this may be an indication that the placenta is not dissolving properly. This can be a serious complication that can lead to severe blood loss. If no heavy bleeding is observed and the rest of the process is unremarkable, the afterbirth can be expected to last slightly longer than thirty minutes. The active ingredient oxytocin, which promotes contractions, is one of the ways of controlling the afterbirth phase and, if necessary, shortening it. It can also be administered as a prophylaxis, i.e. as a preventive measure, in order to guide and control the afterbirth phase in the best possible way.
Complications
In the course of the afterbirth phase various complications can occur. Among the most important complications are dissolution disorders of the placenta. This means that the placenta cannot or can only partially dissolve during postpartum labor and remains in the uterus.
There can be a variety of reasons for this. For example, the placenta itself may have anomalies in which it does not adhere to the uterus as in normal cases, but instead grows through it in parts or even completely (placental retention disorder). In addition, the uterus may have a functional weakness in contraction, uterine atony, in which it is not able to transport the afterbirth outwards by the force of the contractions alone and the placenta remains inside (placenta adhaerens).
Uterus atony is often accompanied by heavy bleeding. Another example of a placental dissolution disorder can be a spasm, i.e. a spasmodic closure of the cervix, whereby the placenta has come loose but is stuck in the birth canal (placenta incarcerata). A blood loss of about 300-500 ml during postpartum is considered normal.
Nevertheless, the disturbed solution of the afterbirth can be associated with a much greater loss of blood and thus represent a vital threat. However, the bleeding is not always visible to the examiner, since the bleeding can also occur inwards and thus remains inapparent at first. In the course of an overlooked incomplete placental solution, severe infections of the uterus up to blood poisoning (sepsis) and bleeding can be complications.