Top: Uterine lining at 5 1/2 months, displaying thin maternal separation from fetus, and high level of placental implantation
Center: Relation of placenta to uterus at 5 weeks and 8.5 months
Bottom: Major arteries and veins of the placenta

Did you know that the placenta is a temporary organ that’s actually created by the fetus, and not the woman?

The human female is a curious creature; like our close great ape cousins, but unlike almost all other mammals, they build up a thick barrier in the uterine wall, to protect against any potential embryo that might implant itself. When there’s no embryo implantation, the thickened wall is shed, in the process known as menstruation.

The thing is, most mammals don’t menstruate. They go into heat, and occasionally shed uterine lining (if the uterus is scratched, or an egg tries to implant but fails, for example), but there’s no regular cycle of bloody discharge relating to breeding. This is because other mammals go through triggered decidualization (developing a uterine lining only when a fertilized egg begins to implant itself), while the great apes (and a couple other convergently evolved families, including bats) experience spontaneous decidualization, where they develop a thick uterine lining during every ovulation, before an egg can even attempt to implant itself.

Why the different linings? Well, it turns out that there are three types of mammal placentas (remember, placentas are developed by the embryo/fetus, not the mother):

1. Epitheliochordal, which is completely superficial, and does not connect in any significant way to the mother’s body. The endometrial epithelium, connective tissue, and uterine epithelium are all preserved and undisturbed in the mother. The fetus is separated from the mother by three layers of tissue. Nutrients and waste are delivered and eliminated through diffusion, rather than direct connection. This group includes equids, swine, and ruminants.
2. Endotheliochordal, which is slightly more invasive to the mother, only preserves the uterine epithelium. Nutrients and waste are not exchanged through direct connection to the mother, but the placenta only leaves one layer of tissue between it and the mother. This group includes cats and dogs.
3. Hemochorial is the most invasive form of placenta in the animal kingdom. The embryo directly hooks itself up to the host (mother’s) blood flow, and leaves no tissue layers between the female and the placenta. This allows much more efficient nutrient transfer to the embryo or fetus, but is also potentially the most harmful to the female since the embryo attaches itself so securely to the uterine wall. The female must develop preemptive measures (a thickened uterine lining) to protect herself from a life-form that is literally driven to take all of the nutrients it needs to develop, and which has adapted to connect itself directly to the host. This group includes elephant shrews, most bats, and most primates.

Interested in more about the science behind reproduction and how amazingly efficient the human embryo is at sucking its host clean, just to obtain its needed resources for development?

PZ Meyers at Pharyngula has an understandable explanation of the article I referenced for this post.

There is also a great site by R. Bowen about the pathophysiology of the reproductive system.

An American Text-Book of Obstetrics for Practitioners and Students. Edited by Richard C. Norris, 1895.

Top: Complete uterine prolapse.
Center and bottom: Female reproductive organs, diagrammatic and in situ.

In healthy women, the uterus is held in place by a “hammock” of ligaments and muscles, most notably the broad ligament, and the uterosacral ligaments. If these ligaments are torn or undergo trauma, they can weaken, and uterine prolapse can occur. The vast majority of uterine prolapse patients only have the uterus fall into the vagina, and further prolapse can often be staved off by Kegel and other exercises.

However, in severe cases (most often in very difficult vaginal births, following difficult pregnancies), both the uterus and vagina can prolapse, and completely evert from the pelvis. In these cases, it’s often only possible to revert and secure the vagina; the uterus is too heavy to suture into place with no natural support, and is generally removed in a hysterectomy.

Anatomy: Descriptive and Surgical. Henry Gray, 1910.
Atlas Iconographique. Dr. S. Laskowski, 1898.