Mothers birthing in a Hospital setting should be proactive and informed about their Hospital's policies regarding the Placenta. The medical staff should always be notified before the birth (ideally in written form such as a submitted birth plan) that you are taking your Placenta home with you. Your plan to take your Placenta home with you should be restated upon hospital admission, and stated again to the OB overseeing the delivery just before birth.
Some Hospitals have policies on Bio-Hazardous materials, requiring a Release of Liability Waiver to be signed, and/or have requirements for how the Placenta must be stored while on Hospital property. It is important to comply to your Hospitals' particular requirements so that you can maintain your rights to your Placenta while on their property.
It is possible your OB could determine that the Placenta needs to go to the Pathology department for examination. A Placenta that has been examined is not usually returned to the parents due to cross contamination with other Bio-Hazardous materials in the examination facility. Even if the Placenta is returned, it is no longer safe to consume.
It is a common Hospital procedure that Placentas are examined in twin births to examine and document Placental, Amniotic Sac, and Umbilical Cord developmental structures. Placentas are also commonly examined in all premature births to determine the cause for prematurity. Numerous other conditions, such as gestational diabetes, IUGR, and meconium, may also flag your Placenta for examination according to some Hospital's policy.
Sometimes the information obtained from Placental examination can affect the medical treatment of the Mother and Child. Sometimes the information obtained will only affect medical treatment for future pregnancies. However, often times, the information obtained is collected exclusively for Hospital paperwork requirements and/or for data collection for a current study being done at that Hospital. Different institutions have varying standards for which Placentas are sent to Pathology; in some Hospitals, the choice is up to the Doctor's discretion.
If medical staff strongly insist that your Placenta be sent to Pathology, you have the right to be fully informed as to the reasons for their recommendation. It is their legal obligation to inform you of why they are recommending the placenta be examined and to answer as many questions as you have about their recommendation.