Separation and Delivery of the Placenta
For 10 to 45 minutes after birth of the baby, the uterus continues to contract to a smaller and smaller size, which causes a shearing effect between the walls of the uterus and the placenta, thus separating the placenta from its implantation site. Separation of the placenta opens the placental sinuses and causes bleeding. The amount of bleeding is limited to an average of 350 mil-liliters by the following mechanism: The smooth muscle fibers of the uterine musculature are arranged in figures of eight around the blood vessels as the vessels pass through the uterine wall. Therefore, contraction of the uterus after delivery of the baby constricts the vessels that had previously supplied blood to the pla-centa. In addition, it is believed that vasoconstrictor prostaglandins formed at the placental separation site cause additional blood vessel spasm.
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