Was your retained placenta mismanaged — and could it be medical negligence?

Understanding retained placenta: what normally happens

After a baby is born, the placenta — the organ that nourished the baby throughout pregnancy — must also leave the body. Doctors call this the third stage of labour. Most of the time, the placenta delivers within 30 minutes of birth.

A retained placenta happens when part or all of the placenta stays inside the uterus after birth. This is a known obstetric complication, meaning clinicians expect it can occur and have clear protocols for managing it. The condition affects roughly two to three percent of births.

Midwives and obstetricians learn to recognise a retained placenta quickly. Standard care involves giving medication to help the uterus contract, attempting controlled cord traction, and — if those steps fail — arranging a procedure called manual removal of placenta (MROP). This procedure takes place under anaesthetic in an operating theatre.

For more general information about pregnancy complications, Healthdirect Australia provides accessible, evidence-based health information for the public.

When things start to go wrong

Not every difficult birth involves negligence. Some complications arise even when clinicians do everything right. However, certain warning signs should prompt immediate action from the clinical team. When the team ignores or delays responding to those signs, harm can follow.

Some women only discover retained placental tissue days or weeks after leaving hospital. A GP or emergency department clinician may find it when the woman returns with ongoing bleeding or infection. That delay in diagnosis can itself cause serious harm.

A common pattern — where care can break down

Retained placenta cases follow recognisable failure patterns. Understanding these patterns can help you identify whether what happened to you matches a known breakdown in care.

Failure to monitor the third stage of labour

No active management of the third stage. Clinical guidelines require midwives and obstetricians to actively manage the third stage of labour. This means giving oxytocin — a medication that helps the uterus contract — and monitoring placental delivery. When the team skips this step or gives the medication too late, the risk of retained placenta increases significantly.

Delayed recognition. Sometimes the clinical team notices the placenta has not delivered but waits too long before escalating. Every minute of delay increases the risk of haemorrhage. A competent clinician acts within the timeframe set by clinical guidelines — not when it becomes convenient.

Inadequate treatment once the problem was identified

Failure to arrange MROP promptly. When medication and cord traction do not work, the standard of care requires the team to arrange manual removal of the placenta under anaesthetic. Some teams delay this step, attempt repeated manual removal without anaesthetic, or fail to involve a senior obstetrician. Each of these failures can cause additional injury.

Incomplete removal. Even after a procedure, fragments of placental tissue can remain. A clinician should confirm complete removal using ultrasound. When the team skips this confirmation step, retained fragments can cause infection or ongoing bleeding that the patient then manages alone at home.

Failures after discharge

Inadequate discharge information. Every woman who has experienced a retained placenta should leave hospital knowing the warning signs of infection and haemorrhage. When the clinical team fails to provide this information, women do not know when to seek urgent help.

Dismissed symptoms at follow-up. Some women return to their GP or hospital with ongoing symptoms and receive reassurance rather than investigation. A clinician who dismisses fever, heavy bleeding, or pelvic pain in a woman who recently gave birth may be failing to meet the standard of care.

The Australian Commission on Safety and Quality in Health Care sets national standards for maternity care, including the management of postpartum complications like retained placenta.

Why this matters legally

Every clinician who treats a patient owes that patient a duty of care. This means the clinician must provide treatment that meets the standard a competent professional in the same field would provide. When a clinician falls below that standard and causes harm, the law may treat that as negligence.

Not every bad outcome after a retained placenta is negligence. Some complications occur even when the clinical team does everything correctly. Retained placenta itself is a known risk of childbirth. The legal question is not whether a complication occurred — it is whether the clinical team responded to that complication in the way a competent clinician would have.

A clinician who delays treatment, misses warning signs, or discharges a patient without confirming complete removal may have breached the standard of care. That breach, if it caused measurable harm, can form the basis of a legal claim. For a broader overview of how this area of law works, see Reframe Legal — Medical Negligence.

When retained placenta may amount to medical negligence

NSW law governs medical negligence claims through the Civil Liability Act 2002. This legislation sets out the rules for proving that a clinician’s conduct fell below the standard of a reasonable professional in the same field. In plain terms, the law asks: would a competent obstetrician or midwife have done what this clinician did?

Several specific scenarios in retained placenta cases may amount to negligence under this standard.

If the clinical team did not give oxytocin after birth, and you developed a retained placenta that led to haemorrhage, the failure to follow active management guidelines may represent a breach of the standard of care.

If the team identified a retained placenta but waited several hours before arranging MROP, and you suffered significant blood loss during that delay, the delay itself may be the breach that caused your harm.

If a clinician discharged you without confirming complete placental removal, and you developed a serious uterine infection or sepsis at home, the failure to confirm complete removal before discharge may be the critical failure.

If a GP or emergency clinician dismissed your symptoms — fever, heavy bleeding, pelvic pain — in the days after birth, and you later required emergency surgery, that dismissal may constitute a failure to meet the standard of care expected of a reasonable clinician.

When harm becomes long-term or permanent

For many women, the harm from a mismanaged retained placenta does not end at the hospital door. The consequences can follow a woman for years — physically, psychologically, and financially.

• 1
  Immediate harm — haemorrhageSevere blood loss during or after birth can require blood transfusions, intensive care admission, and emergency surgery. Some women require a hysterectomy — surgical removal of the uterus — to stop the bleeding. This ends the possibility of future pregnancies.
• 2
  Short-term harm — infection and sepsisRetained placental tissue creates an environment where bacteria multiply rapidly. Uterine infection (endometritis) can develop within days. Without prompt treatment, infection can progress to sepsis — a life-threatening condition requiring intensive care. Some women sustain organ damage as a result.
• 3
  Medium-term harm — Asherman’s syndromeRepeated procedures to remove retained tissue, or severe infection, can cause scarring inside the uterus. This condition — called Asherman’s syndrome — can cause chronic pain, abnormal periods, and difficulty conceiving in the future.
• 4
  Long-term psychological harmBirth trauma is a recognised psychological condition. Women who experienced a life-threatening complication after birth — especially one that was not explained to them — frequently develop post-traumatic stress disorder (PTSD), anxiety, and depression. These conditions affect parenting, relationships, and the ability to work.
• 5
  Financial harmExtended hospital stays, ongoing medical treatment, fertility treatment, psychological therapy, and time away from work all carry financial costs. For some women, the harm is permanent and the financial impact lasts a lifetime.

What compensation can cover in retained placenta cases

NSW law allows people who suffer harm from medical negligence to seek compensation. Compensation — also called damages — can cover several categories of loss.

These categories include pain and suffering, loss of enjoyment of life, past and future medical expenses, past and future lost income, and the cost of care and assistance. In cases involving hysterectomy or permanent fertility loss, courts also consider the profound personal impact of that outcome.

Each case is assessed on its own facts. These figures are general ranges only. A case involving emergency hysterectomy, permanent infertility, and PTSD will attract different consideration than a case involving a delayed diagnosis that resolved without lasting physical harm.

Time limits apply to medical negligence claims in NSW. Generally, a person has three years from the date they knew — or ought reasonably to have known — about the harm and its connection to the clinical care. Acting promptly preserves your options.

Bringing it together — do the pieces fit?

You may be reading this because something felt wrong. Perhaps you are still trying to piece together exactly what happened during or after your birth. That process takes time, and it is entirely normal to feel uncertain.

The legal question is not whether your birth was difficult. It is whether the clinical team met the standard of care that a competent professional would have provided. For a detailed explanation of how claims work in NSW, see Reframe Legal — How Medical Negligence Claims Work in NSW.

You don’t need certainty to understand your position

Many women who experienced a serious complication after birth spend months — sometimes years — wondering whether what happened was normal. Self-doubt is common. Clinicians sometimes tell patients that complications are just “one of those things.” That explanation may be true. It may also be incomplete.

Legal clarity does not require you to be certain that negligence occurred. It requires a careful examination of the facts: what the clinical team did, what the guidelines required, and whether the gap between those two things caused your harm. That examination is the work of a lawyer with experience in this area — not something you need to resolve on your own.

If your retained placenta involved a question about what you were told before any procedure, the principles of informed consent are also relevant. Reframe Legal — Informed Consent and Medical Negligence explains how those principles apply in NSW.

If you have concerns about the conduct of a specific clinician — a midwife, obstetrician, or GP — AHPRA — Australian Health Practitioner Regulation Agency is the national body that registers and regulates health practitioners in Australia. A complaint to AHPRA is separate from a legal claim and focuses on professional conduct rather than compensation.

About the lawyer behind this article

This article is general legal information only. It does not constitute legal advice. Each person’s circumstances are different. The law discussed applies to New South Wales, Australia. Time limits apply to legal claims.