Final answer:
To prevent late postpartum hemorrhage, the obstetrician must inspect the placenta after delivery for intactness. Uterine contractions aid in the process known as involution and breastfeeding facilitates this. Retained placenta requires manual or surgical intervention.
Step-by-step explanation:
To prevent late postpartum hemorrhage, it is essential for the obstetrician to inspect the placenta after delivery to ensure it is intact. This is because any retained fragments of the placenta can lead to postpartum hemorrhage. After the delivery, uterine contractions help both in shearing the placenta from the uterine wall and its expulsion through the vagina, while also reducing blood loss from the placental site.
These contractions continue for several hours and help in the process of involution, which includes the return of the uterus to its pre-pregnancy size and the repositioning of the mother's abdominal organs to their original placement. Breastfeeding also aids this process, facilitating the contractions necessary for involution.
If the placenta does not spontaneously deliver within about 30 minutes, it is considered retained. In such cases, an obstetrician may need to attempt manual removal of the placenta. If this intervention is unsuccessful, surgical removal might be required.