As the popularity of freebirth grows, we're hearing more and more stories about long placental births. Many freebirthing women and new birth keepers share experiences of placental births that take 5, 10, or even 20+ hours. These stories are not uncommon, and they are often shared on freebirth podcasts and facebook groups.
The big question is: Is that normal? Is it okay? What is too long? And why are there so many stories of placentas taking such a long time to come out?
Is It Normal for the Placenta to Take So Long?
Physiologically speaking, long placental births—lasting 10+ hours—are not a variation of normal. The placenta doesn’t necessarily come out when it is ready; it comes out when you are ready. And while these long stories are frequently shared, it’s important to remember that just because something is common, it doesn’t make it a normal part of physiological birth.
I believe it's crucial not to normalise these extended placental births but instead to help women understand what is truly happening so they can have healthy outcomes. A long placental birth can lead to unnecessary complications, and in some cases, medical intervention may become necessary.
Understanding Physiological Birth
Let’s face it—many of us are new to physiological birth, and this lack of understanding can contribute to long placental births. In my experience supporting women outside of the medical system, I've seen that the placenta almost always detaches within the first two hours, and usually within the first hour.
However, many mothers may not realise how much effort is required to birth the placenta. Factors like suction above the cervix, a tight pelvic floor, fear, trauma, and tension can play a role in delaying the placenta’s release.
Why Long Placental Births Happen
Here are four key reasons I believe long placental births happen:
1. Women Underestimate the Effort Required
After giving birth, the mother is understandably focused on her baby. She's also experiencing a powerful hormonal rush and may feel somewhat "out of body" as she relishes in the relief of the birth. For many women, the idea of fully returning to their bodies and exerting effort to birth the placenta can seem overwhelming. Women may not fully grasp how much pushing, pulling, or maneuvering it can take to release the placenta.
Additionally, if they are attended by brand new birth keepers who don’t have experience with physiological placental birth, they may not receive the guidance and support they need.
2. Previous Birth Trauma
Women who have experienced trauma in previous births may enter a state of fear or freeze, especially during a freebirth. This emotional state can make it difficult to release the placenta.
3. Disruptions in the Birth Space
Sometimes, subtle or significant changes in the birth environment can disrupt the physiological process of placental birth. Things like turning on bright lights, separating from the baby, FaceTiming family, taking photos, or getting caught up in conversation can take the mother out of the necessary state of focus and connection to her body. I myself had this experience in my third birth, my placenta took 4 hours because everyone acted like the birth was over! The curtains were opened, my partner emptied the birth pool and a washing machine got delivered!!! It was only once my partner took the kids to the park and everything was calm and quiet, that I was finally able to release the placenta.
Cultural and Generational Trauma Around the Placenta
There is also deep cultural trauma around the placenta. In our society, placentas are often dismissed and treated as biohazard waste. This lack of respect for such an incredible organ has affected how we relate to the placental birth process. Generational trauma from the routine medical extraction of placentas may also contribute to a misunderstanding or fear of this part of birth.
What’s the Risk of Leaving the Placenta In?
In most cases, the placenta will come out naturally within a reasonable time. The real risk of a long placental birth is that, as more time passes, anxiety may increase, leading the mother (or her birth attendants) to seek medical intervention. Once in the hospital, the mother may face unwanted interventions or pressure to take further steps that disrupt the natural process.
In extreme cases, if the cervix begins to close before the placenta is released, it can become physically impossible for the placenta to pass through, which would require immediate medical attention. However, I have yet to see this happen in a freebirth setting.
What to Look For When the Placenta is Ready
The three key signs that indicate the placenta is ready to be born are:
1. A gush of blood signaling placental separation.
2. The cord stops pulsing and turns white.
3. The mother feels heaviness or pressure in her uterus, or experiences mild cramping.
Focusing on the Placenta
As a birth attendant, I make sure that we focus on birthing the placenta after about 1 hour postpartum if it hasn’t come out yet. While the new mother may want to relax, sleep, or bond with the baby, it’s important to help her stay present and bring the birth to completion. A big part of my role is to guide her through any resistance and ensure that she completes the process.
A Community Learning Together
Ultimately, we are still learning. As a community, we are reclaiming birth and rediscovering what physiological birth really is. We are amateurs in some ways, and that’s okay—we are learning as we go. That’s why it’s so important for us to share our knowledge and experiences, to support one another and keep building this movement.
I’d love to hear your thoughts. Did you have a long placental birth? What did you do to get your placenta out, and what worked or didn’t work for you?
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