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  3. Reproduction
  4. Gestation, the placenta and birth

Reproduction · Process

Gestation, the placenta and birth

For nine months one organism lives inside another and takes everything it needs from it — without their blood ever meeting.

Start here

The mother's blood and the foetus's blood never mix.

They are two separate circulations, kept separate for the whole of the pregnancy. And yet the foetus does not breathe, does not eat, and does not use its kidneys — everything it needs arrives, and everything it produces leaves.

So how does oxygen get from one to the other?

At the exchange surface · six substances

Which way does it cross?

0 of 6 checked

Pick a substance, commit to a direction, then check it. Every answer comes from the same rule: things move from where there is more of them to where there is less.

Oxygen

Small molecule · diffusion

The foetus respires like any other organism and cannot use its own lungs — they are full of fluid.

Which way does it cross the placenta?

Choose a direction first.

Forty weeks, in five stages

Building the supply line comes first. Everything else depends on it.

  • Implantation · About five days after fertilisation

    The ball of cells embeds in the thickened lining of the uterus. Part of it will become the embryo; another part immediately begins building the structure that will supply it.

  • The exchange surface is built · Weeks 1–12

    The placenta grows into the uterus wall, folding into thousands of finger-like projections until its surface area is enormous, and the umbilical cord connects it to the embryo. Two circulations are brought within a fraction of a millimetre of each other. Nothing that follows is possible without this.

  • Organs are laid down · Weeks 3–8 · the embryo

    Heart, brain, spine, limbs and every other organ are formed while the embryo is smaller than your thumb. This is the shortest stage and the one where anything crossing the placenta has the largest effect.

  • Growth and maturing · Weeks 9–40 · the foetus

    The organs that exist get bigger and finish developing. The lungs are among the last to be ready, which is why being born early is mostly a breathing problem.

  • Birth · Around 40 weeks

    The muscular wall of the uterus begins contracting and the cervix opens. The contractions push the baby out through the vagina, the umbilical cord is cut, and the placenta — no longer needed — is delivered afterwards.

Key fact

The placenta is an exchange surface, built to the same specification as the alveoli and the villi: a very large surface area, a very thin barrier, and a blood supply on both sides to keep the concentration difference up. The two blood supplies come close enough for substances to diffuse across, and never mix.

The placenta: two bloodstreams, side by side, never joinedTwo drawings side by side. The first shows where the placenta is: the uterus in section with its wall drawn as a band, the placenta as a thick pad against the inside of the wall at the top, and the umbilical cord running from the pad down to a curled foetus, where it joins at the abdomen. Two vessels are drawn in the cord. A dashed marker on the placenta opens out into the second drawing. The second drawing is inside the placenta. The mother's blood is a pale orange field filling the middle. It arrives through the uterus wall at the top right and leaves through the same wall at the bottom right. Three finger-shaped projections called villi reach out into it from the left, and the mother's blood reaches back into the spaces between them, so the two interlock. Each villus is drawn as placenta tissue with a dark unbroken outline, and inside each one a blue vessel arrives from the cord, turns at the tip and returns to the cord: the baby's blood is a closed circuit that never opens. Four arrows cross the wall of the middle villus, oxygen and glucose inward, carbon dioxide and urea outward. Nowhere does a blue vessel meet an orange one, and nowhere is the outline broken.WHERE IT ISWHAT IS HAPPENING INSIDE ITplacentacordthe babyuterus wallthe cord — the baby's ownblood, out and backthe wall — never openmother's blood inand out againoxygenglucosecarbon dioxideureauteruswallThe mother's bloodThe baby's bloodThe placenta's tissue — the wall
Two circulations, brought within a fraction of a millimetre of each other across an enormous surface, and never joined. Trace the blue: the baby's blood leaves along the cord, loops inside a villus, and returns along the cord — a closed circuit. Trace the orange: the mother's blood arrives through the uterus wall, fills the space around and between the villi, and leaves the way it came. Between them, everywhere, is placenta tissue one cell thick. Only substances cross it, and they cross by diffusion, from wherever there is more of them to wherever there is less. Both bloods are red in life; the two colours here say only whose is whose. Follow either one as far as it goes and you never arrive in the other: every villus reaches into the mother's blood and her blood reaches back between them, yet the tissue outline runs unbroken around every villus and along the plate. Substances cross that wall; blood never does.

Think again

“The baby's blood mixes with the mother's blood in the placenta.”

Two circulations, side by side, never joined. If they did mix, two things would go wrong immediately. The first is blood groups: a mother and her baby often have different ones, and mixing incompatible blood makes it clot. The second is pressure — an adult heart pushes blood far harder than a foetal one, and the delicate vessels of the placenta would simply be destroyed. What the placenta does instead is bring the two supplies within a fraction of a millimetre of each other over an enormous folded surface, so that dissolved substances can diffuse across the gap. Everything the foetus receives arrives that way, one molecule at a time, down a concentration difference. The cord is not a pipe carrying the mother's blood; it carries the foetus's own blood out to the exchange surface and back.

“The baby breathes and eats inside the uterus.”

It does neither, and the reason is the same both times: there is nowhere for either to happen. The lungs are full of fluid for the whole pregnancy and no gas exchange takes place in them — the first breath at birth is genuinely the first time they are used, which is why the lungs are among the last organs to be ready and why babies born very early often need help with breathing. Food is the same story in a different organ. Nothing that could be called a meal goes down the umbilical cord: what crosses the placenta is glucose, amino acids and other small molecules already dissolved in blood, which is what the mother's digestive system has spent hours turning food into. The foetus is supplied at the end of somebody else's digestion.

Mastery ladder

Not started yet.

Rungs 3 and 4 you mark yourself.

Rung 1 · Read the surface

Why does oxygen move from the mother’s blood into the foetus’s blood at the placenta?

Rung 2 · The one that catches people

A student says the umbilical cord carries the mother’s blood into the baby. What is wrong with that?

Rung 3 · Explain the surface

Explain how the placenta supplies a foetus with oxygen and glucose and removes its carbon dioxide and urea, without the two bloods mixing. Name the three features that make it a good exchange surface.

Rung 4 · Take it somewhere new

Alveoli, villi and the placenta are three different organs in three different systems. Explain what problem all three are solving, what design features they share, and one way the placenta’s problem is harder than the other two.

Key note

Gestation is the time from fertilisation to birth, about 38 weeks in humans — the familiar 40 weeks is counted from the first day of the last period. The placenta is the exchange surface between two separate circulations: oxygen, glucose and other small molecules diffuse in from the mother's blood, carbon dioxide and urea diffuse out into it, and the two never mix. The umbilical cord carries the foetus's own blood to and from the placenta. Organs are laid down in the first eight weeks; the rest is growth. At birth the uterus muscle contracts, the cervix opens, the baby is delivered, and the placenta follows.

Going further

The placenta is not the mother's organ. It grows from the same ball of cells as the embryo, so its cells carry the embryo's chromosomes — half of them from the father — and it is the only organ a human being ever builds, uses and then discards. That raises a question nobody has fully answered. An immune system attacks tissue whose cells it does not recognise; that is why transplanted organs are rejected without drugs to prevent it. Yet here is an organ, and an entire foetus, carrying a set of foreign proteins, growing inside another person's body for nine months, pressed right up against her blood supply, and normally not attacked at all. Several mechanisms are known — the outer layer of the placenta displays unusual surface proteins, and the immune response in the uterus is locally dialled down — but how they add up to nine months of tolerance is still an active research question. The most ordinary event in biology is also one of its stranger unsolved problems.

Before this lesson

  • This follows on from The menstrual cycle.

Connects to

At GCSE this becomes

  • Exchange surfaces compared quantitatively, the hormones of pregnancy and birth, and the ethics of antenatal screening.

Where to next

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