The amazing placenta

The placenta is an amazing organ - it has the sole responsibility of keeping a baby alive for the first 8-9 months of their life. Everyone who has ever taken a breath has done so because of a placenta. It is the only organ I can think of that has such an important function, yet has a limited life span (yes, organs such the tonsils or appendix may be removable with little side effects, but they do not play such an important role maintaining life). I also believe that it is a very misunderstood organ.

Lets look at what we do know about it

This organ originates from the same cells that make the baby, so technically it belongs to your baby.

It acts as the lungs, digestive system, and liver of your baby while in the uterus. The baby in the uterus lives in fluid, there is no air to breath, so the placenta provides oxygen to the baby and removes carbon dioxide from the baby. The baby will also not be taking in any food/milk and so must get nutrients from the mother, which is provided via the placenta. The liver usually filters out any toxins or waste from the blood (the kidneys also do this to a degree, but they will start working and produce urine during pregnancy - fun fact, the baby wees while inside the womb and then swallows the amniotic fluid, which in turn becomes urine), but the liver does not really reach its full potential until after birth, so the placenta does this for the baby.

The placenta also transfers antibodies and hormones to the baby. It releases a hormone called progesterone which will prevent you from making milk during pregnancy - if you have a placenta inside you, there must be a baby in the womb, ergo there is no need to produce milk.

When I became a midwife I obviously came up close and personal with many placentas, and I developed a healthy respect from them. Many of my NICU colleagues tease me for how in awe I am of the placenta. But think about it for a moment - this somewhat unattractive organ literally provides life to your baby.

They may not be terribly attractive, but they provide life!

Myths about the placenta

However, I am saddened to see many negative myths about the placenta being spread, especially by some of my midwifery and NICU nurse colleagues. These include the age old 'the placenta will stop working if you stay pregnant for too long' and 'your placenta was unhealthy'.

Please can someone tell me which other organ in an otherwise healthy human body just suddenly stops working? Now before you say 'oh but your kidneys or liver can stop working' - yes, they can but there is usually an underlying cause for this.

And the same can be true for the placenta - high blood pressure, diabetes, smoking, infection can negatively affect the placenta. But I want proof that a placenta can stop working, without warning, and with no underlying cause....

The argument for that is that risk of still birth increases the further along in gestation you get - sometimes it is presented as 'for every week that you are pregnant beyond 39 weeks your risk of still birth doubles'. Before you go and book your induction for 39 weeks lets look at some numbers....

Different studies have produced different numbers, but in summary, where there are no other risk factor, the risk of still birth at 39 weeks is 0.03-0.09%, this increases to approx. 0.04% - 0.07% at 40 weeks, 0.04% - 0.1% at 41weeks, and 0.07 - 0.1% at 42 weeks (taken from the Evidence Based Birth on Due Dates). In my opinion these numbers are incredibly low, but I recognise that different people may have different interpretations on risks vs benefits - so what you decide to do with that information is up to you.

But I am yet to see any definitive proof that these stillbirth have been cause by the placenta failing - yes, there is a theoretical risk that it is the cause, but there is no proof, and until we have definitive proof I am going to remain in awe of the placenta....

What can you do to honour the incredible job the placenta has done

For many decades, maybe even centuries, the placenta has been cut from the baby and removed from the mother very quickly after birth and then thrown in the clinical waste bin, to be burned along with other waste. I believe this is an incredibly tragic mistake. As I've said before - this organ has been solely responsible for keeping your baby alive. Without it, your baby would not have grown, they would not have received oxygen, they would not have received precious antibodies and nutrients.

What you decide to do with the placenta is completely up to you - it is an organ that grew from the same cells as your baby, so technically you have the right to decide what happens to it. Honouring it can range from looking at it and thanking it in the birth room for providing life to your baby, to keeping it and planting it. Some cultures perform ceremonies to honour it, some recommend planting it in a particular place. Over the last few years many businesses have popped up who make 'DNA jewellery' - jewellery from things like the placenta, breast milk, hair, and even ashes of those who have passed away.