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Beware of dangers of retained placenta

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Giving birth is a miracle of nature. It is loaded with many uncertainties, which can develop at any stage of the process. One such problem is the retention of placenta, which may occur, in the third stage of labour when the placenta and membranes are supposed to be delivered.

UNDERSTANDING THIRD STAGE OF LABOUR…

The third stage of labour refers to the period following the completed delivery of the newborn until the completed delivery of the placenta and its attached membranes. This stage involves one actively delivering the placenta and its membranes by actively pushing it out. It usually takes 10 to 20 minutes but may take up to an hour by natural effort. This process can however be speeded up by giving an injection (syntoncin) in the thigh. The injection helps the uterus to contract, separate the placenta, assist in placenta delivery and reduce the risk of heavy bleeding. This treatment shortens placenta delivery to within five to ten minutes.

HOW RETAINED PLACENTA OCCURS…

A retained placenta occurs when all or part of the placenta or membranes remain inside the uterus after childbirth. The delivery of the tissues should ideally be completely delivered within one hour of baby birth. For some women, however, the placenta does not deliver naturally and must be physically removed.

DIFFERENT TYPES…

There are different reasons for the placenta to be retained for longer than is normal:

Uteriny atony. The uterus stops contracting or doesn’t contract enough to aid the placenta to separate.

Trapped placenta. The placenta detaches from the uterus but becomes trapped behind the cervix. This usually occurs when the umbilical cord is cut or snaps off, or when the cervix closes too early before the placenta is delivered.

Placenta accrete. An area of the placenta remains attached because it is deeply embedded in the uterine wall. This prevents detachment.

Succenturiate placenta. A small piece of the placenta, which is connected to the main part of the placenta with blood vessels, is left inside the uterus.

CAUSES…

Among the reasons a placenta is retained include:

Full bladder. This alone may cause placental retention and it is advisable to empty bladder before delivery.

Associated problems. If the uterus is not well contracted, blood vessels in the uterus are therefore not well closed and the woman continues to bleed after delivery.

Late placenta delivery. Delivery of the placenta after more than 30 minutes when the baby has been born increases the risk of excessive bleeding, a condition known as post partum haemorrhage (PPH).

Small-retained pieces of placental tissue may not be detected immediately. This may cause heavy bleeding after 24 hours (secondary PPH). Such an occurrence may even take place six weeks after delivery.

Infection. This is also a known complication of retained placenta. After removal of the placenta, the mother should be put on antibiotics.

PREVENTION…

Once placenta is retained, there are high chances of it happening again in following pregnancies. Retained placenta is more common in premature births. This should, therefore, be closely evaluated after premature delivery. Due to the cord snapping or the cervix closing up too quickly, managed or natural third stage labour may be offered in the next delivery.

TREATMENT…

Treatment of retained placenta depends on the cause. Breastfeeding and nipple rubbing causes the uterus to contract. This helps the placenta to separate and therefore be expelled.

Changing to a more upright position, from a sitting or lying position helps the placenta to separate due to the force of gravity. Injection of oxytocin and controlled cord traction prevents retention of the placenta. This is active management in placental delivery.

Manual removal of the placenta under anaesthesia can be done in theatre. The bladder must be emptied first before this is done. Manual removal can involve a doctor placing their hand inside the uterus and gently removing the placenta from the uterine wall. When the placenta is separated, the doctor can then take hold of the placenta, remove it from the uterus through the vagina. Emptying the bladder can effectively assist in the removal of the placenta.

In case of prolonged heavy bleeding, pelvic ultrasound scan can be done to study the uterine cavity. If there are any retained parts, evacuation can be done in hospital followed by antibiotics. In cases where the placenta has deeply grown into the uterus, removal is only possible by hysterectomy. A hysterectomy is the surgical removal of the uterus. A woman who undergoes a hysterectomy will be unable to carry any future pregnancies.

RISKS…

A retained placenta is a potential life-threatening situation. After the placenta is delivered, the contraction of the uterus causes the blood vessels within it to constrict. If the placenta is retained, the uterus is unable to perform this function. If the blood vessels are not closed off, they continue to bleed, which could cause loss of a large amount of blood and possibly require blood transfusions.

A retained placenta, specifically in instances where placental debris is left within the uterus, can cause severe infection and fertility issues. Labour and delivery professionals are trained and aware of the signs and symptoms of retained placenta and know how to treat them accordingly. Incidences of retained placenta are actually quite few.

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Cover Story

Elizabeth Nzisa: The Firstborn Who Became a Mother Overnight

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While most teenagers spend their days focused on school, friendships, and dreams for the future, Elizabeth Nzisa, fondly known as Shiku, was forced to grow up much faster than she ever imagined. At only 17 years old, she found herself taking on the role of a mother to her three younger siblings after her family was hit by tragedy not once, but twice.

Her story, shared in an emotional interview, is a powerful reflection of strength, sacrifice and the deep bond between siblings. Elizabeth recalls the moment her life changed completely. Her mother died while giving birth to their youngest sibling, a baby boy. In the middle of that painful loss, their father walked away from the family, leaving Elizabeth alone with a newborn and two other young children to care for.

Mama yetu alipass 2024, Feb. Alipass akipata haka katoto kadogo. Dad naye akatuacha akaenda

 

Becoming a Mother Too Soon

She explains that she had no choice but to step up and become the parent in the house. She raised her youngest brother from the day he was born, and to this day he calls her mum, not knowing she is actually his big sister. That detail alone shows how much responsibility she carried at such a young age. She became the provider, the protector, the caregiver, and the emotional support for her siblings while she was still trying to understand life herself. With little help from relatives, Elizabeth had to find ways to survive, balancing school when she could, doing small jobs and making sure her siblings were fed, safe and loved.

The journey was not easy. She faced financial struggles, emotional exhaustion, and the pressure of trying to stay strong even when she felt overwhelmed. There were moments when she doubted herself and wondered if she was doing enough. Still, her story is not about defeat. It is about endurance. Elizabeth talks about finding strength through faith, support from the people around her, and the determination to keep her family together no matter how hard things became.

Over the years, she made sure her siblings stayed in school, had food on the table, and grew up feeling loved despite everything they had lost. What could have been a completely broken home became a family held together by her sacrifice and commitment.

Many viewers reacted emotionally, saying the story moved them to tears. Some described firstborn daughters as second mothers, while others said her life shows the kind of courage people rarely see but should never forget.

 

Click here to read our March issue 2026

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Cover Story

Elizabeth Nzisa: The Firstborn Who Became a Mother Overnight

Published

on

While most teenagers spend their days focused on school, friendships, and dreams for the future, Elizabeth Nzisa, fondly known as Shiku, was forced to grow up much faster than she ever imagined. At only 17 years old, she found herself taking on the role of a mother to her three younger siblings after her family was hit by tragedy not once, but twice.

Her story, shared in an emotional interview, is a powerful reflection of strength, sacrifice and the deep bond between siblings. Elizabeth recalls the moment her life changed completely. Her mother died while giving birth to their youngest sibling, a baby boy. In the middle of that painful loss, their father walked away from the family, leaving Elizabeth alone with a newborn and two other young children to care for.

Mama yetu alipass 2024, Feb. Alipass akipata haka katoto kadogo. Dad naye akatuacha akaenda

 

Becoming a Mother Too Soon

She explains that she had no choice but to step up and become the parent in the house. She raised her youngest brother from the day he was born, and to this day he calls her mum, not knowing she is actually his big sister. That detail alone shows how much responsibility she carried at such a young age. She became the provider, the protector, the caregiver, and the emotional support for her siblings while she was still trying to understand life herself. With little help from relatives, Elizabeth had to find ways to survive, balancing school when she could, doing small jobs and making sure her siblings were fed, safe and loved.

The journey was not easy. She faced financial struggles, emotional exhaustion, and the pressure of trying to stay strong even when she felt overwhelmed. There were moments when she doubted herself and wondered if she was doing enough. Still, her story is not about defeat. It is about endurance. Elizabeth talks about finding strength through faith, support from the people around her, and the determination to keep her family together no matter how hard things became.

Over the years, she made sure her siblings stayed in school, had food on the table, and grew up feeling loved despite everything they had lost. What could have been a completely broken home became a family held together by her sacrifice and commitment.

Many viewers reacted emotionally, saying the story moved them to tears. Some described firstborn daughters as second mothers, while others said her life shows the kind of courage people rarely see but should never forget.

 

Click here to read our March issue 2026

Continue Reading

Cover Story

Endometriosis and sex: How to make intimacy pain-free

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There is no doubt that endometriosis can affect a woman’s way of life. The condition slews a couple of conditions, painful sex being one of them. Penetration pulls and pushes any tissue growth behind the vagina and lower uterus.

Although symptoms may differ from woman to woman, here are some things you can do to lessen your pain and ensure you have some good time:

Take a dose of painkillers

Take an over the counter painkiller that sits well with your body before intercourse and incase pain persists, take another one as prescribed.

Track your cycle and try at certain times of the month

Most women with endometriosis experience excruciating pain during their period and ovulation. Keep track of your cycle so that you can know when you are ovulating. You can use apps like my calendar and flo period tracker to track your periods. This will help you know when best to engage in sexual intercourse.

READ ALSO: Crucial Facts About Endometriosis Everyone Should Know About

Use lube

Vaginal dryness is not something to be ashamed of and if you happen to have it, lube should be your best buddy. Make sure to use any silicon or water based lubricant anytime you feel like your vagina is dry. Ensure the application is of good amount to achieve a wet area.

Explore alternatives

Talk with your partner about things that turn you on and bring you pleasure. Just to mention a few; mutual masturbation, foreplay, kissing and mutual fondling. Sex does not have to mean intercourse.

Try different positions

Experimenting different positions can teach you and your partner which ones hurt and the ones that bring direct pleasure with no or less pain. Positions that are considered better vary from person to person so take the time to explore and learn yourself with your partner.

Find the right rhythm

Finding the right rhythm can help you experience less discomfort during sex. Quick thrusting or deep penetration can aggravate pain. Talk to your partner about that which you do not like and find ways that will satisfy the both of you like exchanging positions so that you can control the speed and rhythm.

Bottom line

Intimacy does not have to be boring, painful or make you hate the condition that you have. Talk openly about your feelings around sex and penetration and what would help to ease your concerns.

Our FREE  e-paper March Issue is here!
As we celebrate our women this month, we bring you the best stories and the most inspiring features to get you going.
Click HERE to read!

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