Nursing Component Task
Nursing procedures & clinical learning

Midwifery (RM)

Examination of the Placenta

Placental examination after birth checks completeness of the placenta and membranes and identifies abnormalities that may explain bleeding or affect newborn care. Missing tissue or abnormal findings require prompt escalation.

Purpose

  • Confirm placenta and membranes are complete
  • Identify retained tissue or abnormality
  • Support investigation of bleeding and documentation of birth

Indications

  • After every birth
  • Postpartum haemorrhage, retained placenta, abnormal cord, or concern about fetal or maternal condition
  • Placental examination requested for clinical or pathology reasons

Equipment

  • Gloves, apron, and protective surface
  • Placenta tray or clean examination area
  • Good light, measuring scale if required
  • Specimen container and labels when indicated
  • Records and waste receptacle

Preparation

  • Check the birth record and have a clean area, PPE, labels, and pathology instructions ready.
  • Ensure bleeding and uterine tone are assessed alongside the placenta.

Procedure steps

  • Confirm maternal and newborn identity and the time and mode of delivery.
  • Perform hand hygiene, wear appropriate PPE, and place the placenta on a clean protected surface.
  • Inspect the maternal surface for complete cotyledons, colour, clots, infarcts, or missing tissue.
  • Inspect the fetal surface, membranes, edges, insertion, vessels, and cord length or abnormalities.
  • Assess for accessory lobe, torn membranes, retroplacental clot, foul odour, or other abnormality.
  • If incomplete or abnormal, retain the placenta safely and notify the authorized clinician immediately.
  • Send a specimen to pathology only when ordered and label it accurately.
  • Dispose of waste safely and perform hand hygiene.
  • Explain relevant findings to the woman when appropriate and continue bleeding surveillance.
  • Document examination, completeness, abnormalities, specimen, communication, and plan.

Precautions

  • Use PPE and standard precautions because the placenta and blood are body fluids.
  • Do not discard a placenta before confirming completeness or an authorized decision.
  • Treat suspected retained tissue or haemorrhage as urgent.
  • Avoid making a pathological diagnosis beyond scope.

Aftercare

  • Continue monitoring maternal bleeding and uterine tone.
  • Communicate abnormal findings during handover.

Nursing considerations

  • Use a systematic inspection and correlate with maternal symptoms.
  • Ensure chain of custody for specimens.

Patient education

  • Explain that the placenta is checked to ensure no tissue remains and to understand bleeding when relevant.
  • Tell the woman to report heavy bleeding or feeling faint.

Documentation

  • Record completeness, membranes, cord, maternal and fetal surfaces, abnormality, specimen, communication, and plan.
  • Document the examiner and time.

References and further reading

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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