The Obstetric Intellect: When the Placenta Becomes Velcro

In a normal pregnancy, the placenta attaches to the uterus like a strip of velcro pressed lightly against fabric. After delivery, a gentle tug and it peels away. That’s what normally happens.

Several years ago, I stood in the operating room preparing for what should have been a routine repeat cesarean delivery. The patient was familiar to me. Years earlier, I had delivered her first baby by cesarean after more than 24 hours of labor without progress beyond five centimeters.

This second time, everything began as expected. We opened the skin, t…