Retained Placenta
胎衣不下 · tāi yī bù xià+3 other namesHide other names
Also known as: Incomplete Placental Expulsion, Placenta Retention, Retained placenta or lochia
Retained placenta is never just a mechanical failure - it signals an underlying pattern of blood stasis, Qi deficiency, heat, or yin depletion. When used alongside standard care, TCM can reduce the need for manual removal and support faster uterine recovery, with many women noticing improved lochia and energy within days.
About this page · what it is and isn't
What this is. A plain-English synthesis of how classical TCM and modern clinical research describe retained placenta. Patterns and herbs come from canonical TCM sources; clinical claims are cited in the Evidence section.
What it isn't. A diagnosis. Me&Qi is an editorial team, not a licensed clinic. The pattern quiz is a thinking tool — pulse and tongue still need a person in the room. Anything in the Safety section should send you to a doctor, not a herb.
Last reviewed Jun 2026.
Educational content about Traditional Chinese Medicine — not medical advice. See a qualified practitioner for diagnosis and treatment.
Conventional treatments
Where conventional treatment falls short
How TCM understands retained placenta
TCM views retained placenta through the lens of the Chong and Ren vessels - the body's deepest channels for blood and reproductive essence. After delivery, these vessels must close and the uterus must contract strongly to push the placenta out. When blood flow in these vessels becomes stagnant - often from exhaustion, cold, or emotional strain - the placenta becomes trapped. This is why blood stasis is a common thread in almost every case of retained placenta.
But stasis is rarely the whole story. In many women, the deeper problem is Qi deficiency: the body is simply too drained after labor to generate the force needed to expel the placenta. The uterus feels weak and ineffectual, and the mother may be profoundly exhausted. In other cases, heat has entered the blood chamber, making the blood thick and sticky - like glue holding the placenta in place. This pattern often comes with fever and foul-smelling lochia.
Finally, some women have a long-standing depletion of Kidney and Liver yin, leaving the uterus undernourished and unable to contract properly. This is more common after prolonged or difficult labors. Each of these four patterns - pure stasis, Qi deficiency with stasis, heat and stasis, or yin deficiency - requires a different treatment strategy, which is why TCM always tailors the approach to the individual mother.
「产后胞衣不出，由产时用力过度，或产时血出多，胞衣干涩，或由血入胞中，胞衣胀大，故不得出。」
"After childbirth, the placenta does not come out because of excessive straining during labor, or because too much blood was lost, causing the placenta to become dry and stuck, or because blood enters the placenta, making it swell and unable to be expelled."
How a TCM practitioner diagnoses retained placenta
Inside the consultation
A TCM practitioner starts by asking about the sensation in the lower abdomen, the colour and smell of any lochia, and how tired the mother feels after delivery. The quality of pain, the presence of heat signs, and the mother’s overall strength quickly narrow the picture toward one of the four main patterns, each of which points to a different underlying imbalance.
When Blood Stagnation in the Directing and Penetrating Vessels (冲任, Chong Ren) is the driver, the pain is sharp and stabbing, and a firm lump may be felt low in the belly. Lochia is dark with clots, the tongue is purplish with possible stasis spots, and the pulse feels wiry or choppy. The absence of marked exhaustion or fever distinguishes this pattern from the others.
If Qi Deficiency causing Blood Stagnation is at play, extreme fatigue and weak, ineffectual contractions are the hallmark. The lochia tends to be pale and scant rather than dark, and there is little odour. The tongue looks pale, puffy, and tooth-marked, while the pulse is deep, weak, and choppy. The key difference is profound exhaustion rather than intense pain.
Heat and Blood Stagnation in the Lower Burner brings a very different picture: fever, restlessness, and lochia that is dark, thick, and foul-smelling. The lower abdomen is acutely tender. The tongue is reddish-purple with stasis spots and a dry yellow coating, and the pulse is deep, choppy, and rapid. The presence of heat signs is what sets this pattern apart from the others.
Kidney and Liver Yin Deficiency is less acute and often reflects long-term constitutional weakness. The mother may report lower back soreness, dizziness, night sweats, and a dry mouth. Contractions feel weak, and the retained placenta is due to insufficient essence rather than forceful stasis. The tongue is red with little coating, and the pulse is thin, rapid, and wiry.
TCM Patterns for Retained Placenta
In TCM, the aim is to address the root cause, not just the symptom — it calls that root cause a “pattern.” The same retained placenta can come from several different patterns, each treated differently. The quickest way to find yours is the quiz below.
Find your pattern
Tap any sign that fits how yours feels.
- 1Your signs
- 2What makes it worse
- 3What helps
Which signs match your experience?
It is common to see a bit of yourself in more than one pattern, because blood stasis is central to all of them. Qi deficiency can easily lead to sluggish blood flow, and stasis that lingers can generate heat. A mixed picture is normal, especially in the exhausted postpartum state, and does not mean the diagnosis is wrong.
To get a clearer sense of which pattern dominates, notice the strongest sensation: sharp, fixed pain suggests stasis; overwhelming exhaustion points to Qi deficiency; fever and foul discharge point to heat; and chronic lower back soreness with dryness points to yin deficiency. The timing and what makes you feel worse can also help differentiate.
Because retained placenta is a medical emergency, this self-assessment is for understanding, not for treatment. If you have a retained placenta, seek immediate medical care. TCM can support recovery, but a professional diagnosis with tongue and pulse examination is essential to safely select herbs and acupuncture points.
Kidney and Liver Yin Deficiency
Treatment
Four ways to address retained placenta in TCM — explore each, or take the quiz to see what fits you first.
Formulas traditionally used for retained placenta
4 formulas across the patterns above. The right one depends on your pattern — start with the quiz if you're unsure which fits.
A classical formula used to break up blood stasis and clear heat from the lower abdomen. It is commonly applied for lower abdominal pain with a sense of tightness and fullness, dark-coloured menstrual blood or stools, restlessness, and nighttime fevers caused by stagnant blood binding with heat in the lower body.
A classical postpartum recovery formula used to help the body expel residual Blood and tissue (lochia) from the uterus after childbirth, relieve lower abdominal cold pain, and support the formation of new, healthy Blood. It works by gently warming the body and promoting circulation in the uterus, making it one of the most widely used formulas for postpartum care in the Chinese medicine tradition.
A classical formula that strengthens both Qi and Blood while gently activating blood circulation. It is built from two foundational tonifying formulas combined with Motherwort, and is especially used for women experiencing irregular, scanty, or delayed periods due to underlying weakness and poor blood flow.
A classical formula designed to deeply nourish Kidney Yin and replenish the body's vital essence and marrow. It is used when there is significant depletion of the body's fundamental nourishing fluids and substances, leading to symptoms such as dizziness, lower back and knee weakness, night sweats, dry mouth and throat, and a general state of thinning or exhaustion. Unlike milder Yin-nourishing formulas, Zuo Gui Wan is a purely replenishing formula without any draining ingredients, making it suitable for more severe deficiency.
Because retained placenta is a medical emergency, TCM is typically used after the placenta is delivered or to address incomplete expulsion. Herbal formulas are taken for 3-7 days to clear stasis and promote lochia. For Qi deficiency patterns, tonics may be continued for 2-4 weeks to rebuild strength. Yin deficiency recovery may take 1-3 months of consistent herbal and dietary support.
Treatment principles
Treatment always aims to invigorate blood and promote uterine contraction to expel the placenta, while addressing the root cause. Herbs like Yi Mu Cao (Leonurus) and Tao Ren (Peach Kernel) are staples for moving blood; they are combined with Qi tonics like Huang Qi (Astragalus) when the mother is exhausted, or with heat-clearing herbs like Da Huang (Rhubarb) when fever and foul discharge are present.
Acupuncture points on the lower abdomen and legs - such as Sanyinjiao (SP-6) and Hegu (LI-4) - are used to stimulate uterine contractions.
The exact formula and points are chosen based on whether the pattern is primarily stasis, Qi deficiency, heat, or yin deficiency, and they are adjusted as the mother's condition evolves.
What to expect from treatment
In an acute setting, herbal decoctions are often given every few hours to encourage placental expulsion. Acupuncture can be applied immediately, with points like Sanyinjiao (SP-6) and Hegu (LI-4) stimulated to promote contractions. Once the placenta is delivered, treatment shifts to clearing any remaining lochia and rebuilding strength.
Most women notice less bleeding and cramping within 1-2 days of starting herbs. For Qi deficiency patterns, tonics may continue for 2-4 weeks; yin deficiency recovery may require 1-3 months of consistent herbal and dietary support. Progress is monitored through lochia color, energy levels, and pulse quality.
General dietary guidance
Combining TCM with conventional treatment
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Safety & special considerations
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Placenta not delivered within 30 minutes of birth — This is a medical emergency requiring immediate attention to prevent hemorrhage and infection.
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Heavy vaginal bleeding soaking more than one pad per hour — Postpartum hemorrhage can be life-threatening and needs urgent medical intervention.
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Severe abdominal pain or cramping — Intense pain may indicate uterine rupture or other complications that require emergency care.
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Fever over 100.4°F (38°C) or chills — Fever after delivery can signal a serious infection that needs prompt antibiotic treatment.
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Foul-smelling lochia or discharge — A foul odor suggests uterine infection and requires medical evaluation.
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Dizziness, fainting, or rapid heartbeat — These may be signs of significant blood loss or shock and require immediate emergency care.
Audience-specific guidance — open what applies to you
Most herbs used for retained placenta - such as Yi Mu Cao (益母草), Tao Ren (桃仁), and Chuan Xiong (川芎) - are generally considered safe during breastfeeding when used in standard postpartum doses, as they help clear stasis and promote uterine contraction without harming milk supply. However, strong purgative herbs like Da Huang (大黄) should be used with caution and only under professional guidance, as they can pass into breast milk and cause infant diarrhea.
Acupuncture is an excellent option for breastfeeding mothers because it avoids any herb-drug transfer through milk. Points like Sanyinjiao (SP-6) and Zusanli (ST-36) can strengthen Qi and promote uterine contraction, while Xuehai (SP-10) and Zhongji (REN-3) help resolve blood stasis. All are safe and can even support lactation by improving overall Qi and blood circulation.
Evidence & references
Rigorous clinical trials on TCM for retained placenta in humans are scarce. Most evidence comes from veterinary studies, such as a 2024 trial showing that the herbal formula Guixiong Yimu San reduced retained placenta rates in dairy cows and improved reproductive outcomes. Human data are largely limited to observational studies and expert consensus documents that support the use of blood-moving formulas like Sheng Hua Tang to promote uterine contraction and placental expulsion.
The TCM approach is biologically plausible: herbs like Yi Mu Cao and Chuan Xiong have demonstrated uterotonic and anti-inflammatory effects in laboratory studies. However, well-designed randomized controlled trials are needed to establish efficacy and safety in postpartum women. In current practice, TCM is best used as a supportive measure alongside standard obstetric care, not as a replacement for manual removal or surgical intervention when indicated.
Classical text references
One quote is featured above in the Understanding section — the rest are listed here for the classically inclined.
「产后胞衣不下，多因血入衣中，胀大不得下，或产时用力太过，或产前血虚，或外受风寒，皆令气血凝滞，故胞衣不下也。」
"Retained placenta after childbirth is mostly due to blood entering the placenta, causing it to swell and not descend, or excessive straining during labor, or pre-existing blood deficiency, or external invasion of wind-cold. All of these cause Qi and blood to congeal and stagnate, so the placenta does not come out."
Fu Ren Da Quan Liang Fang (Complete Good Formulas for Women)
Chapter on Postpartum Disorders
Frequently asked questions
Common questions about using Traditional Chinese Medicine for retained placenta.
Retained placenta is a medical emergency. You should seek immediate Western medical care - do not delay. TCM can be used alongside emergency measures to support uterine contraction and lochia expulsion, but it should never replace urgent manual removal or medication. Once the placenta is delivered, TCM herbs and acupuncture can help clear remaining stasis and speed recovery.
Yes, when prescribed by a qualified TCM practitioner who knows you are breastfeeding. Many postpartum herbs, such as Yi Mu Cao (Leonurus) and Dang Gui (Angelica), are traditionally used to support lactation and recovery. However, some herbs can pass into breast milk or affect milk supply, so self-prescribing is never safe. Always inform your practitioner and your baby's pediatrician.
Acupuncture can stimulate uterine contractions within minutes to hours when applied at specific points like Sanyinjiao (SP-6) and Hegu (LI-4). It is often used in hospital settings alongside conventional care. In cases of incomplete expulsion, a single session may be enough to trigger the needed contractions. For ongoing recovery, treatments are typically given daily or every other day for the first week.
Addressing the underlying pattern - whether it's Qi deficiency, blood stasis, or yin depletion - can strengthen the uterus and improve its contractile function, potentially reducing the risk of recurrence. Many women choose to work with a TCM practitioner during a subsequent pregnancy to build Qi and blood and ensure smooth delivery. However, every birth is unique, and no treatment can guarantee prevention.
Absolutely. After manual removal, TCM herbs and acupuncture can help clear any remaining blood stasis, reduce pain, promote uterine involution, and rebuild your energy. This can speed healing and lower the risk of infection or prolonged bleeding. Just be sure your TCM practitioner knows about all procedures and medications you received.
Warm, easily digestible foods are best. Bone broths, congee with ginger and red dates, and lightly cooked vegetables help replenish Qi and blood. Avoid cold drinks, raw salads, and icy foods, which can constrict the uterus and worsen stasis. If you had fever or signs of heat, choose cooling but still warm foods like mung bean soup, and avoid spicy dishes.
Blood stasis is almost always involved in retained placenta, but it is often secondary to another imbalance. For example, Qi deficiency can cause sluggish blood flow that leads to stasis; heat can thicken the blood into stasis; and yin deficiency can leave the uterus too dry to expel the placenta. So while invigorating blood is a key part of treatment, the root cause must also be addressed for full recovery.
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