When must the afterbirth be manually released?
There are several reasons to solve a afterbirth manually, i.e. by means of special handles or medical maneuvers. This can be, for example, a prolonged afterbirth phase that lasts far more than thirty minutes or is accompanied by heavy bleeding. The active ingredient oxytocin can also be used here to promote placental dissolution and reduce bleeding.
In addition, every afterbirth is checked for completeness. When assessing the surface of the placenta, attention is paid to whether it is intact, as an irregular surface can be a sign of residual placenta in the uterus. Furthermore, the course of the vessels of the placenta is assessed. If particularly large vessels are visible here, which run from the placenta to the egg skins, this can be a sign of a second placenta still remaining in the womb. If there is a suspicion that tissue may have remained in the uterus, this is an indication to manually resolve the afterbirth.In addition, in some cases and if the solution is incomplete, a curettage, i.e. scraping, may be necessary.
How painful is the afterbirth?
The afterbirth phase is in most cases not very painful. The birth canal is already dilated and pre-stretched by the already delivered baby, so that the soft tissue of the placenta rarely causes pain when passing through the vaginal canal. The postpartum phase is accompanied by postpartum contractions, whereby the contractions of the uterus are significantly milder in intensity than the preceding birth pangs. In some cases, the afterbirth pains are sufficient to give birth to the placenta, but often a light pressing of the patient can be helpful.
What can be done about the pain?
Most patients complain of severe pain during the actual birth process while the child is passing through the birth canal. The postpartum phase itself is in most cases hardly painful. For this reason, targeted drug pain relief only for the afterbirth phase is rather unusual. For the entire birth process, which then also includes the afterbirth, there is the possibility of epidural anesthesia, i.e. a regional blockade of pain transmission and processing. This is usually applied early on and the cervix is only slightly opened to absorb the pain of childbirth in time and reduce its intensity.
