Manual Removal of Placenta
Procedure for Manual Removal of Placenta [Demonstration]
Purpose: To be able to perform a manual removal of placenta
15-30 minutes 
Safe Delivery App, MamaNatalie, elbow long gloves (if available)
Video subchapter “Remove the Placenta”
Demonstrate the procedure for manual removal of placenta by going through these 8 steps.
Then, have participants practice the procedure in pairs. One participant demonstrates the procedure and the other one goes through the checklist and makes sure that each step is done correctly. Afterwards, they switch roles.
- Insert a hand into the vagina and follow the cord into the uterus
- Place the other hand on top of the fundus to support the uterus
- Keep the fingers tightly together and move the hand slowly from side to side until the edge of the placenta is located
- Use the edge of the hand to gently separate the placenta from the uterine wall
- The uterine wall is very fragile so be careful not to apply unnecessary force
- Proceed slowly all around the placental bed until the placenta is detached from the uterine wall
- Hold the placenta and slowly withdraw the hand while the other hand provides a counter pressure in the other direction
- Palpate the uterine cavity to ensure that all placental tissue has been removed