Here's how health care providers analyze the awe-inspiring organ, during pregnancy and following birth, to get a read on both parent and Baby.

By Maressa Brown
December 05, 2019
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Rarely has one organ in the human body commanded the spotlight like the placenta. The thick membrane, replete with blood vessels that help deliver nutrients and oxygen to your baby and take away waste products to keep your baby healthy, has been lauded for all the amazing things you can do with it after giving birth. There's a practice known as placentophagy, which despite lacking scientific support, involves consuming the placenta for all its wonderful nutrients. You can turn it into a body salve to treat C-section scars and perineal tears. But for health care providers, the placenta's usefulness begins during pregnancy and extends to postnatal care, because it is basically a window into the health of parent and baby.

In a new social media post, a midwife asked followers to check out photos of four placentas and guess which was the unhealthy one. (Fair warning, if you're squeamish: The photos are graphic.) Here, experts weigh in on there merit of analyzing the placenta in this way—and what a placenta's appearance actually says about a parent or baby's health.

The Case for Analyzing the Placenta After Birth

A certified nurse midwife (CNM) named Angelina Ruffin-Alexander recently shared a photo collage of four placentas alongside a powerful PSA: "We as midwives always analyze the placenta after a birth," Ruffin-Alexander wrote. She pointed out that one of the placentas in her post was "NOT healthy," as the "mother/baby were malnourished with severe hyperemesis gravidarum (HG), leading to a 34-week stillborn."

The midwife concluded, "This can be one of the reasons good prenatal care is recommended."

Sherry Ross, MD, OB-GYN, a women’s health expert at Providence Saint John’s Health Center in Santa Monica, California, agrees that there's much we can learn from the placenta, as it is, in her opinion, the "heart" of the pregnancy. "A healthy placenta provides all the nutrients and oxygen needed for a growing baby to thrive during the entire pregnancy," Dr. Ross says.

She points out that certain circumstances or conditions can make the placenta less healthy, strong, and effective for a growing baby, such as high blood pressure, diabetes, anemia, twin pregnancy, tobacco, alcohol and drug use, and a blood-clotting disorder.

And in a study published in BJOG: An International Journal of Obstetrics and Gynecology, researchers concluded that pregnancies complicated by HG in the second trimester of pregnancy are at a much higher risk of associated placental dysfunction disorders.

What You Can Tell From the Placenta During Pregnancy

Well before a baby is born, health care providers analyze the placenta as part of your routine prenatal care, says Martin Chavez, M.D., F.A.C.O.G., chief of the Division of Maternal-Fetal Medicine and director of Fetal Surgery at NYU Winthrop Hospital. They do this in two ways:

"There are chemical and hormonal tests, including screening analytes from a maternal blood sample, which provides insight into maternal and fetal health during pregnancy, as well as genetic issues," Dr. Chavez says. "Analytes help determine a risk-profile for early preeclampsia, early delivery, or abruption, which is the early premature separation of the placenta, which can be life-threatening for both mother and baby. They also provide insight into fetal growth restrictions, prematurity, or other adverse effects of the pregnancy."

Doctors will also use ultrasound to visualize concerns with the placenta, Dr. Chavez says. Paired with the blood test, this will give doctors an overall view of pregnancy health.

What You Can Tell From the Placenta After Giving Birth

As Ruffin-Alexander noted, health care providers will visually examine the placenta following the birth. One of the main attributes they consider is its size. "When you see a placenta for a baby who is a certain gestational age, you expect it to be a certain size," Dr. Chavez says. "When you have a term baby, and the placenta is much smaller than you anticipate it to be, you would start speculating that there was a nutritional issue that might have occurred during the pregnancy."

Calcifications or clots are other traits that might indicate that the placenta was compromised.

Risk factors for calcifications include:

  • Smoking
  • Pregnancy-induced hypertension
  • Placental abruption (when the placenta becomes dislodged from the wall of the uterus)
  • Certain bacteria in the placenta
  • Environmental factors including exposure to radiation or low-frequency sound
  • Reactions to medication (antacids) or vitamin supplements (excessive calcium)

Risk factors for placental blood clots are:

  • Previous blood clots
  • A genetic predisposition to blood clots
  • Obesity
  • Prolonged immobility (e.g., bed rest, long-distance travel)
  • Multiple births
  • Increased maternal age
  • Other medical illness (e.g., cancer, infection)

Dr. Chavez says doctors will also send the placenta for pathology testing. This can offer insight into issues like inflammation, vascular abnormalities of the placenta, or infection (referred to as chorioamnionitis and stemming from a variety of bacteria like E. coli, group B streptococci, and anaerobic bacteria). "If there is evidence of infection, the neonatalogist can make adjustments to that baby’s care, such as prescribing antibiotics," he points out.

Ultimately, analyzing the placenta after birth will provide doctors not only with information on the current pregnancy and birth but potential insight and treatment options to preempt concerns during future pregnancies, Dr. Chavez notes.

The Bottom Line

While every birth-giver and new baby deserves and requires quality prenatal care, that's not necessarily the only takeaway here, says Dr. Chavez. After all, by analyzing the placenta, you can't tell if the parent had excellent prenatal care or not.

"Unfortunately, there are some outcomes we cannot prevent," Dr. Chavez notes. "By having good prenatal care, we can possibly not only eliminate but reduce some of these outcomes. Not all of them." For instance, some patients who suffer from HG don't respond well to treatment. That said, shaming or blaming parents for not taking good care of their health before or during a pregnancy isn't productive.

Ultimately, Dr. Chavez encourages people who are trying to conceive and expectant parents to be as healthy as possible before getting pregnant and to obtain prenatal care as early as possible during their pregnancy. And he says that if you do have an adverse outcome—whether for the mother or the baby or both—it's crucial to get as much info as possible, including placental pathology and a consultation with a high-risk obstetrician, to improve the outcome for future pregnancies.

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