The placenta is a temporary organ that develops during pregnancy to facilitate the exchange of nutrients, oxygen, and waste products between the mother and the developing fetus. Immediately following the birth, the placenta, commonly referred to as the afterbirth, is expelled from the uterus. Hospitals follow strict protocols to determine its fate, which depends on the clinical situation, institutional policy, and parental decisions. For most deliveries, the process begins with a careful inspection by the attending medical team.
The Standard Path: Examination and Disposal
The first step after delivery is a thorough visual examination performed by the physician or midwife in the delivery room. This quick inspection is standard care, designed to ensure the organ is complete and that no fragments have been retained within the uterus, which could cause serious complications like postpartum hemorrhage or infection. The provider inspects the placenta’s maternal side for completeness, checking that all lobes, or cotyledons, are present and that the organ is intact.
The fetal side is also examined, noting the number of vessels in the umbilical cord—typically two arteries and one vein—and checking for any abnormalities in the membranes or attachment points. The size, shape, and consistency of the entire structure are assessed, and any unusual features like clots, discoloration, or lesions are documented in the patient’s record. If this initial assessment appears normal and there are no specific clinical indications for further testing, the placenta is designated for routine disposal.
In the absence of parental requests or medical necessity, the placenta is categorized as anatomical or pathological medical waste, a type of biohazardous material. This classification requires specialized handling separate from general trash to mitigate infection risks. Hospital staff place the placenta into a biohazard bag or specific container and ensure it is properly sealed and labeled.
The placenta then enters the hospital’s regulated medical waste stream, which is managed by specialized contractors. Disposal typically occurs through high-heat incineration, a controlled process that safely reduces the biological material to ash. Hospitals must adhere to strict environmental and safety regulations for this process.
When Pathology Testing Is Required
If the initial examination reveals any gross abnormality or if complications arose during the pregnancy, labor, or delivery, the placenta is diverted for formal pathological analysis. This specialized testing provides a microscopic understanding of events that may have affected the mother or the infant. The decision to send the placenta to the pathology lab is based on specific clinical indications, not routine practice for every birth.
Reasons for mandatory submission include adverse pregnancy outcomes such as fetal growth restriction, preterm delivery before 32 weeks, stillbirth, or neonatal death. Maternal complications like severe preeclampsia, placental abruption, or evidence of infection also trigger a pathology request. The pathologist examines tissue samples under a microscope, looking for signs of inflammation, infection, blood clots, or structural problems that could explain the adverse outcome.
The findings from this detailed analysis are invaluable for the medical team, offering insights that may guide the immediate care of the infant or mother. The pathology report also provides crucial information for family counseling and planning future pregnancies, helping to identify conditions that carry a risk of recurrence. The placenta tissue blocks and slides are often retained as part of the permanent medical record.
Options for Parent Retention and Keepsakes
A growing number of parents choose to take their placenta home after delivery for personal, cultural, or ceremonial purposes, diverging from the medical waste stream. This option is generally permitted, but it requires careful advance planning and adherence to specific hospital and state regulations. Parents should notify their care team early in the pregnancy to understand the necessary steps and paperwork.
The hospital requires parents to sign an informed consent or liability waiver, acknowledging that once the placenta is released, the hospital is no longer responsible for its handling or use. State laws and individual hospital policies vary significantly, so parents need to confirm their facility’s specific rules regarding release. Some cultural traditions involve ceremonially burying the placenta to connect the child to their home and heritage.
Logistics for transport are stringent, as the placenta contains blood and is treated as a biohazard outside of a medical context. The organ must be properly sealed in a leak-proof container and labeled before leaving the facility. It is crucial that the placenta has not been sent to pathology or preserved with chemicals like formalin, as this would make it unsuitable for retention and any intended personal use, such as encapsulation.
Donation for Research and Therapeutic Use
Donation is a pathway for the placenta, where it is repurposed for medical research and the development of therapeutic products. This process is distinct from both routine disposal and personal retention, requiring explicit parental consent and a rigorous screening process. The placenta is a rich source of tissue, including the amniotic membrane, which contains valuable cells and proteins.
Donated placental tissue is primarily used in regenerative medicine, particularly for creating biological grafts and wound dressings. These products are effective in treating severe burns, chronic wounds like diabetic foot ulcers, and in various surgical procedures, including gum grafts and nerve repair. The tissue’s natural properties help to reduce pain and inflammation while promoting faster healing.
The donation process is coordinated with specialized birth tissue procurement organizations, which handle the collection, testing, and processing. Donors must undergo a medical history review and blood screening to ensure the tissue is free of infectious diseases. Placentas from planned Cesarean section deliveries are often preferred due to the higher likelihood of sterility compared to those from vaginal births.