Are long placental births a variation of normal?
Written by Emilee Saldaya
As freebirth and RBK-attended homebirth rises in swift popularity, many stories are emerging of long placental births. I'm often told by freebirthing women and new RBK's that to deliver the placenta, it took upwards of 10, 20, 30+ hours. You'll find these stories often on the podcast and in our private membership where women share their personal freebirth stories frequently.
I'm often asked -- is that normal? Is that ok? What is *too long? Why exactly are there so many stories about the placenta taking so long to come out?
The placenta doesn’t (always) come out when its ready. It comes out when *you’re* ready. Placental birth taking upwards of 10+ hours and beyond is *not* a variation of normal, in the physiological sense.
Just because the stories are common, doesn’t exactly mean it’s a variation of normal in a physiological sense.
I don’t want to normalize long placental births. Instead, I want to share with you what I understand about physiological birth so that you know how to get your placenta out in a healthy way and to help other women as well.
Let’s face it, most of us are either totally ignorant to, and/or totally new to physiological birth. And that ignorance manifests in a few ways that can create long placental deliveries.
Here is what I observe:
The placenta *almost* always detaches in the first two hours. Really — in the first hour, but I’m going to be generous and say two. Almost always, the placenta is detached, and ready to come out, but the mother doesn’t yet know how much effort it may require. I think for “tougher” placentas, it could be the case that suction gets created above the cervix, as well as a tight pelvic floor, trauma, fear, tension, resistance, and other things mixing into the picture.
I have attended many births outside the system, and virtually supported many many more, as well as interviewed and debriefed with hundreds more.I have a significant pool of experience and stories to pull from on this topic. To be blunt, I really think ignorance plays the largest part in this!
I could break it down into 4 layers of ignorance (not the nicest word choice, but really I’m just trying to say simply *not knowing*)
Women have no idea how much effort it may take, or what to do about it. The birthing mothers energy is often, understandably, all over the place after she’s given birth. She’s often hyper-focused on the baby, experiencing the peak eruption of the hormonal cocktail, and still in a rather other worldly state of relief. So the notion that she now needs to come entirely back into her body, the room, get into a new position, and focus on what can be thought of as pushing again, can feel like a BIG, even impossible task. I don’t think most women that are birthing their placentas on their own for the first time could really grasp how hard you may have to tug, push, cough, and maneuver the placenta. *Then we add that women birthing with brand new birth keepers also may not be getting any good advice or help and guidance from them, which can complicate things.
Women are traumatized by the abuse they endured in their previous births and go into a freeze/scared state when they freebirth.
Women don’t understand it as a part of the birth process, and disrupt the scene. This can be subtle or massive -- things like turning lights on, showering, separating from baby, FaceTiming, pictures, letting people come in, calling people for suggestions on the phone, getting fear mongered, on and on.
Women use it as another way to create drama, self sabotage, and maintain old story lines. Sounds harsh but…it’s also sadly true. Lots to say about that but I’m going to leave it there for now.
Not to mention the unspeakable multi-generational trauma around the placenta and the horrific routine extraction of this incredible organ — imagine what that has done to our relationship to our placentas. Our culture holds no acknowledgment or respect for it. Hospitals call it a biohazard and then sell it to slime-balls for thousands of dollars behind our backs.
So what’s the cost of this? I’m not sure if it’s a problem, necessarily. A worst case scenario is the cervix begins to close up and the placenta literally can not fit back through, which would be bad. But I don’t personally know any women who have freebirthed where this happened to them. It is also just super uncomfortable and the birth is simply *not* over.
I think the biggest risk of leaving it in is the likelihood that the woman (or her people) gets worried/scared and dramatic about it and heads into the hospital increases with every hour. And we know what they do to her in the hospital.
The basic three things you're looking for is the separation gush of blood, the cord stopping pulsing and going white, and the mother will likely feel a heaviness or pressure and/or cramping in her uterus.
As a birth attendant, I’ve never dealt with a long placenta birth because we are aggressively and entirely focusing on it unless it’s out from about 40 minutes postpartum onwards. That said, I have been to countless births where the woman just wants to lay down, sleep, eat, FaceTime her parents, and run away from the job getting done. But, we don’t do that, we get the placenta out, so that she can truly be done. Part of my job is to shepherd her through the resistance, and help her bring her birth to completion.
And it's noteworthy that the majority of women attending other women in birthing outside the medical system are brand new to physiological birth. We don't yet have many seasoned authentic midwives, (though we are working on it through The Radical Birth Keeper School!).
We as a community are very very new to all of this, as we are collectively “taking birth back” we are also learning what birth really is, how to support it, how to heal from the enormity of our painful history, and in that, we have to be graceful and patience with being…amateurs, in a way. Being new to all of this. Learning as we go.
Which is why this community is so very important, at this time in this movement - to share knowledge, share our stories, support each other, answer each others questions, and have patience with women new to these ideas. We are building something together that has ripples of great impact further than any of us can see.
Supporting healthy placental birth is one of the new workshops we are adding to this upcoming round of The Radical Birth Keeper School. If you want to attend women birthing outside the system and be as prepared as possible, join us!
There is just over a week left to apply and get $1000 off the tuition, if accepted into the program.
I want to hear your thoughts -- did you have a long placental birth? What did you do to get it out? What worked, what didn't? Hit reply and let me know!