The amniotic sac, though strong enough to hold a baby, or multiple, for a full term pregnancy, is also very delicate. As baby’s head tears through the sac to come down and out, it’s possible the sac can become torn apart and small or large pieces left behind, even after the placenta emerges.
This is called “trailing membranes.” It is more likely to happen if the placenta is delivered Duncan side, because the amniotic sac is pulled on, as the Duncan side emerges before the Shultz side.
Most of the time, it will come out on its own within the next few hours, but sometimes, as the cervix begins to close after birth, the remaining sac can get trapped, and it is difficult to know, as a provider or support person, that there is sac remaining inside.
As the sac tries to come out itself, it may feel like heavy pressure on the mamas cervix and a small stringy fleshy piece may hang out and seem very scary to the mom!
At this point, the mom or her partner may twist from the bottom point where the piece is hanging, up to the top where the cervical opening begins and gently tug on the piece, and continue to twist and pull, gently but firmly, until it comes out.
It may also be helpful to have mom take garlic, high dose Vitamin C and an herb that would cause uterine contraction such as Motherwort or Cohosh. Nursing frequently will help bring contractions as well. Mom or a partner can gently massage her belly to help the uterus along, too.
IF a mom presents a fever, nausea, smell, foul discharge, heavy bleeding, or any other symptom that may indicate further retainment, she should seek medical attention to help cleanse the remaining pieces.
If you want to learn more about the placenta and amniotic sac, check out our Placenta Course!