Manual removal of the placenta is a procedure sometimes required when the placenta does not deliver on its own after the baby is born. Typically, the placenta separates and is delivered within 30 minutes of birth, but in some cases, it remains attached to the uterine wall — a condition known as retained placenta. When gentle traction on the umbilical cord and uterine massage fail to deliver the placenta, the next step is manual removal. This involves the provider inserting a hand into the uterus to separate and extract the placenta, often requiring pain management or anesthesia depending on the situation.

Prompt management of a retained placenta is essential to prevent complications like heavy bleeding (postpartum hemorrhage) or infection. After removal, the uterus is typically massaged firmly to stimulate contraction and minimize blood loss. In some cases, medications like Pitocin or antibiotics may be used. Although it can be an intense experience for both patient and provider, manual removal of the placenta is a life-saving skill — a critical part of birth work that ensures safe recovery after delivery.

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